Bilateral Hip Replacement

What is a "Simultaneous" Bilateral Total Hip Replacement (BTHR)?

In a simultaneous procedure both hips are replaced in one operation, on the same day under one anesthesia.  This means that there is one hospitalization and one recovery period.  Certain patients are at higher risk for medical complications if they undergo simultaneous bilateral hip replacement surgery. Your physician will discuss with you the relative merits and safety of simultaneous BTHR.

What is a "Staged" Bilateral Total Hip Replacement?

The staged procedure means that both hip replacements take place as two separate surgical events. Surgeries are planned to be performed several monthsapart one from the other, requiring two hospital stays, two episodes of anesthesia and two rehabilitation periods. The time between surgeries may vary depending upon your individual medical condition but most surgeons will want you torecover about 3 months from the first surgery before you undergo the second surgery.

  Why would I need to get a BTHR?

The most common reason for a Bilateral Total Hip Replacement is severe arthritis that is causing pain and stiffness in both hips interfering with activities of daily living and significantly reducing one’s quality of life. Stiffness can be significant making simple tasks such as putting on your shoes and socks very difficult.  Pain is usually worsened with weight bearing activities, such as standing and walking. Arthritis of the hip is a progressive condition that usually worsens with time.

The ideal candidate for a simultaneous total hip replacement would be a younger, healthier, non-obese individual with stiffness, pain, and limitation of activities that significantly reduces one’s quality of life.


What are the advantages of a Simultaneous Total Hip Replacement?

The advantages of having a simultaneous hip replacement in the properly selected patient include: only one surgical event, one episode of anesthesia,shorter overall hospital stay and the ability to rehabilitate both new hipreplacements at the same time.

What are the advantages of a Staged Total Hip Replacement?

The advantages of having a Staged procedure includes lower stress level for the cardiovascular system (heart and lungs) as well as a lower risk of requiring blood transfusion after surgery. In general, elderly and/or obese patients and those with serious medical issues are best treated with a staged procedure. Your surgeon will help you decide what the best choice is for you.

Who would not be a candidate for Simultaneous Bilateral Total Hip Replacement?

This procedure is not encouraged in older or obese patients with substantial health conditions, such as heart, lung, and/or vascular disorders.  These patients would be at increased risk for significant perioperative complications.


Potential Complications

What are the disadvantages of a simultaneous bilateral hip replacement?

The simultaneous procedure may require a longer hospitalization and a more intense period of rehabilitation.  While most patients who receive simultaneous BTHR can go home after surgery, some patients may have to go to a rehabilitation facility.

What are the disadvantages of a Staged BTHR?

The disadvantages of having a Staged procedure is that it requires two hospital stays, two episodes of anesthesia and delays full return to work from disability as compared to simultaneous hip replacement.


What are the results in terms of function and relief of pain?

The ultimate success of the operation should be the same in both the simultaneous and staged procedures. 

Your surgeon is the best source to help you decide what’s best for you.


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