A hip replacement, also known as total hip arthroplasty, is a surgical procedure designed to replace a damaged hip joint with artificial components. This intervention aims to relieve pain and improve mobility for individuals whose hip joints have deteriorated. The question of whether it is common to require both hips to be replaced is a frequent consideration for those facing hip issues. This article explores the commonality of bilateral hip replacement, the reasons behind it, and the different surgical approaches available.
How Often Do Both Hips Need Replacing?
While single hip replacement is a widely performed procedure, bilateral hip replacement is less common. Studies indicate that approximately 6% of all hip replacement surgeries involve bilateral replacement. This procedure occurs less frequently than unilateral (one-sided) procedures. It is sometimes observed more in men than women, with an average age of patients around 66. Despite its lower frequency, it remains an effective treatment option for individuals with significant issues in both hips.
Why Two Hips Might Need Replacement
The necessity for both hips to be replaced often stems from medical conditions that affect joints symmetrically. Osteoarthritis is a common cause, where cartilage wears away, causing bone-on-bone friction, pain, and stiffness. It is estimated that osteoarthritis affects both hip joints in about 42% of individuals, and a quarter of these may eventually need both joints replaced.
Other conditions that can lead to the need for bilateral hip replacement include inflammatory arthritis, such as rheumatoid arthritis, which causes widespread joint inflammation. Avascular necrosis, a condition where the blood supply to bone tissue is disrupted, can also affect both hips, leading to joint damage. Developmental conditions, like hip dysplasia, where the hip joint forms improperly, can also predispose individuals to early and bilateral hip deterioration.
Approaches to Bilateral Hip Replacement
When both hips require replacement, orthopedic surgeons consider two main approaches: simultaneous or staged. Simultaneous bilateral hip replacement involves replacing both hips during a single surgical procedure. This approach offers advantages like a single hospital stay and one rehabilitation period, potentially reducing overall costs.
Conversely, a staged bilateral hip replacement involves replacing each hip in separate operations, usually with several weeks or months between the procedures. The decision between these two approaches depends on various factors, including the patient’s overall health, age, medical conditions, and the surgeon’s preference. Simultaneous surgery is often reserved for younger, healthier patients who can tolerate a longer procedure and greater blood loss. While simultaneous procedures may have a reduced hospital stay and lower total cost, some studies have noted a potential for increased risk of certain complications, such as pulmonary embolism, compared to staged procedures.