Bi-lateral Hip Replacements: Simultaneous vs Staged
Hip Replacements occur most commonly due to degenerative problems from osteoarthritis. Some individuals have this in both hips and require both of them to be replaced. There is always the question as to whether or not they can be done at the same time, a simultaneous bi-lateral hip replacement, or if they need to be done at different times, a staged bi-lateral hip replacement.
In a properly selected patient, there are benefits to having a simultaneous bi-lateral hip replacement. Those benefits would include: one hospital stay, only being put under anesthesia one time, and the ability to rehabilitate both hips at the same time. There are, however, disadvantages. Those could include a longer hospital stay as opposed to an out-patient procedure and a more intense period of rehabilitation. Most often, you can go home on the same day after your surgery, however, some patients might have to be admitted directly to a rehabilitation facility or stay a day or two in the hospital.
In a staged bi-lateral hip replacement, the advantages are: a lower stress level for the cardiovascular system and lower risk of blood transfusion. The disadvantages of a staged bi-lateral hip replacement include: being put under anesthesia two times and additional time required before you can return back to work or normal day to day activities. The average time in between the surgeries is typically 3 months. That means, it could be 6 months before you return back to work.
Ultimately, the success rate for a bi-lateral hip replacement done simultaneously vs staged has the same outcome as long as there are no post-operative complications. It all comes down to the surgeon’s opinion on whether or not you are a good candidate as well as the surgeons experience and efficiency in doing them.
Only a skilled surgeon should do a bi-lateral hip replacement. If they take 3.5-4 hours to do a uni-lateral hip replacement, then they are not the right surgeon because the longer you are under anesthesia, the more complications, such as blood clots, can occur. The surgeon needs to have a track record of completing a uni-lateral hip replacement in approximately 1-1.5 hours, or it might not be in your best interest. Additional things they consider when selecting the proper candidate are the patients age, BMI, previous and current medical history, and activity level prior to surgery. Being younger and healthy are the criteria for the best candidates.