Bilateral Hip Replacement
Everything You Need To Know About Bilateral Hip Replacement
Bilateral hip replacement is done routinely, presenting one of the highest success rates of body part replacement surgeries. Depending on your situation and the surgeon, you may have one hip joint replaced and then the other in a separate surgery which is usually several months apart or you can have them done simultaneously. When you have one surgery done at a time, it is really a long process because you need two hospital visits, two anesthesia treatments and then two separate rehabilitation and recovery periods. Although having just one surgery is more convenient, it is painful and rehabilitation is incredibly difficult.
Who Is A Good Candidate?
Patients of nearly any age can be a good candidate for bilateral hip replacement. If you have stiffness or severe pain in both hips that makes your life miserable or restricts your daily activities, this is an ideal procedure for you. This is also a perfect opportunity for individuals with a deformity of the hips that constantly impairs the lumbar spine. Fixed deformity imposes a great deal of strain on your lower back so if this is the case, you probably experience more symptoms in your spine than you do your hips. Also, individuals who have osteoarthritis in their hip joints and who happen to be contemplating having total knee replacement should definitely have both of their hips done first.
If you have one good hip but both show signs of osteoarthritis on an X-ray, you are still a good candidate but you should only have one hip done. You probably will need the good hip replaced at a later time because it shows signs of osteoarthritis but you do not need to have it done right away.
Choosing Staged Or Simultaneous
Deciding whether to have bilateral hip replacement done on one side at a time or all together is a big decision to make. Having one side done (staged) puts a lot less stress on your circulatory system and heart so this is a smarter choice for older patients or those who have circulatory, cardiac and pulmonary diseases. Obviously, the biggest disadvantage is that it is a drawn out experience having to go through everything twice.
Simultaneous surgery puts a lot of stress on your body so candidates are very thoughtfully selected. Only individuals who are free of any cardiac, pulmonary and circulatory diseases and those who are in good physical health are considered. They must also be under 75 years old and the decision has to be made after discussing the process with a cardiologist, surgeon and the anesthesiologist. Individuals considering this surgery must have adequate muscle condition because the rehabilitation is harder and you will need to rely on your arms a lot. Literally, for the first few weeks, you don't have a good leg to stand on.
Bilateral hip replacement is performed under general epidural or spinal anesthesia. It is not uncommon to use a variety of methods.
- General – With this type of anesthesia, the patient is completely asleep during the entire bilateral hip replacement. A ventilator is often used to assist with breathing and patients typically feel groggy or drowsy after the procedure. Today, newer anesthetic drugs have decreased post-operative vomiting and nausea significantly.
- Epidural or Spinal Block – These types of techniques block the passage of any nerve impulses being delivered to the spinal cord. This type of block can be placed at different spinal levels and the patient typically cannot feel anything from the waist down. A ventilator is not required but the individual is sedated. This method reduces anesthesia risks substantially. Depending on what type of medication is used, pain relief can usually still be received for several hours after the bilateral hip replacement has been completed. Since there is sensation loss below the waste that is experienced temporarily, a urinary catheter is typically inserted.