Bilateral Hip Replacement

Overview

The bilateral hip disorder is a common finding that could happen in around 42 percent of the populace with osteoarthrosis, and it’s estimated that 25 percent of individuals with osteoarthritis requiring total hip replacement may require a bilateral replacement. This has resulted in the test of the greatest strategy to run a hip replacement without raising the probability of perioperative comorbidities, using as alternatives a simultaneous bilateral hip replacement or a sequential operation.

Types of Bilateral Hip Replacement

• Simultaneous bilateral hip replacement – Both hips are replaced at the same time in one operation.
• Staged bilateral hip replacement – Both hips are replaced at different time intervals.
• Hip resurfacing – Resurfacing the original socket and ball of the thigh bone. It has a lower risk of dislocation and allows a return to high-level physical activity.
• Minimally invasive total hip replacement – Reduces delicate tissue damage, resulting in shorter healing time and fewer post-surgical complications.

Diagnosis for Hip Replacement Surgery

• Osteoarthritis – Degenerative joint disorder causing bone-on-bone friction.
• Rheumatoid arthritis – Autoimmune inflammation of the synovial membrane.
• Trauma – Severe hip injury damaging articular cartilage.
• Necrosis – Bone collapse due to insufficient blood flow.
• Developmental dysplasia – Congenital hip dislocation.

Tests Before Surgery

• Medical history evaluation
• Physical examination for joint stability
• X-rays and MRI

Symptoms Indicating Surgery

• Persistent pain despite drugs or therapy
• Limited mobility
• Difficulty performing daily activities
• Trouble rising from a seated position

Cost Factors in India

• Medication and treatment duration
• Hospitalization and geographic location
• Surgeon’s expertise
• Type and frequency of diagnostics
• Hospital reputation and infrastructure

Procedure

Before Surgery

• Evaluation including medical history, blood tests, urine analysis, ECG
• Imaging for disease assessment
• Medication review

During Surgery

• Replacement of femoral head and acetabulum with prosthesis
• Duration: ~3–4 hours
• Performed under general/spinal anesthesia
• Removal of damaged cartilage and placement of prosthetics
• X-ray verification and suturing
• Cast application for ~2 weeks

After Surgery

• Pain and antibiotic medications
• Hospital stay: 6–8 days
• Stitches removed in ~2 weeks
• Daily activities resumed in 3–6 months
• Physical therapy is crucial in first 6 weeks

Complications

• Infection, blood clots
• Nerve damage
• Limp or walking difficulty
• Grinding or clunking in hip
• Leg length inequality

---

Frequently Asked Questions

Q: What is Osteoarthritis?
A: Degenerative disorder where cartilage wears off, leading to stiffness and pain.

Q: Age group for hip replacement?
A: Mostly 60–80 years, but not limited to elderly.

Q: Surgery duration?
A: Around 3–4 hours.

Q: Recovery period?
A: Few weeks to months, depending on age and health.

Q: Why do replacements fail?
A: Loosening of the prosthetic components.

Q: When is surgery not advised?
A: Severe osteoporosis, dementia, alcoholism, or active infections.

Q: Tips for better recovery?
A: Gentle exercises, avoid high-impact work, consult doctor for postures and activities.

Q: Surgery options?
A: Ceramic-on-ceramic, ceramic-on-polyethylene, hydroxyapatite coated stems, etc.