Bilateral Hip Replacement

Undergoing one hip replacement procedure can be daunting enough. However, for some patients, a double hip replacement may be recommended, where both hips are painful and badly damaged by arthritis.

While less common than a single (unilateral) hip replacement, having both hips replaced at the same time (bilateral), can deliver significant benefits to some patients. Here, we’ll look at when two hip replacements may be better than one and what to expect from a bilateral procedure.

What is a bilateral hip replacement?

Hip replacement involves replacing the femoral head and the acetabulum, using artificial parts made of ceramic, metal or a mixture of both. A bilateral hip replacement can be done as a staged, or simultaneous procedure.

With a staged procedure, the hip joints will be replaced one at a time. After the first procedure, the second replacement will be carried out a few weeks later.  In a simultaneous procedure, both hip joints are replaced at the same time.  This approach is cheaper and overall the hospital stay, recovery period and cost is less.

Generally speaking, a simultaneous procedure isn’t recommended for older patients or those who have other underlying health problems. If both your hips are very painful, you should talk to your surgeon to discuss the risks and benefits of each method. They will be able to advise the best technique to match your circumstances.

Why might you need two procedures in one?

A number of conditions can damage the joint, leading to the need for replacement surgery, including osteoarthritis, osteonecrosis, developmental dysplasia and rheumatoid arthritis.  Osteoarthritis in particular frequently affects both hips.  Studies have revealed that 42% of those suffering with Osteoarthritis have it in both hips and of these, around 25% go on to need both hips replaced.

Recovery and results

Patients who undergo a simultaneous procedure will typically need to stay in hospital for a couple of days longer than after one hip, typically 4 or 5 days. Patients are mobilised as soon as possible – on the day of surgery, or the following day.  Pain control techniques are very important to allow this.  Early movement, along with blood thinning medication reduces the risk of clots, which is one of the most significant risks of hip replacement.

Physical therapy is key to achieving best results. A trained physiotherapist will teach you stretches and exercise to improve the mobility of the joints. Recovery time and results will depend upon a number of factors such as age and overall health.

Despite their benefits, double hip replacements are quite rare. Patients who are experiencing pain and mobility issues in both joints should speak to a hip specialist to discuss your treatment options. Mr Simon Bridle will be able to talk through the staged and simultaneous techniques and advise you of which one is better suited to you.