Simultaneous Bilateral versus Unilateral Total Hip Replacement

When a hip replacement procedure is performed on both hip joints in a single surgery, it becomes a simultaneous bilateral hip replacement. People with degenerative joint diseases like osteoarthritis and rheumatoid arthritis can benefit from this surgery. When there is a loss of movement and severe pain in both hip joints that affects the quality of life of the patient, simultaneous bilateral hip replacement is performed.

What is unilateral and bilateral hip replacement?

Unilateral hip replacement is a procedure in which a single hip joint is replaced with an artificial hip prosthesis. However, a bilateral hip replacement procedure is performed on both hip joints at the same time. Most of the time, patients have only one joint affected by a degenerative joint disease, but in severe cases, both hip joints become involved, and both of the hip joints need to be replaced with an artificial prosthesis.

After surgery, most people can resume their daily activities after some time, typically with little to no hip pain.

What benefits come with a simultaneous bilateral total hip replacement?

Simultaneous bilateral hip replacement is a single surgery and does not require two surgeries separately for each hip joint. Some of the significant advantages may include:

Simultaneous bilateral hip replacement does not require separate anesthesia for two hip replacement procedures.
Hospital stay for bilateral hip replacement is the same as a single hip transplant procedure.
There are fewer chances of complications from anesthesia.
It is less expensive than two surgeries.
A single rehabilitation program is needed for both hip replacements.

Bilateral hip replacement procedures are usually performed on young patients who are in good general health and can tolerate the surgery.

In which patients is simultaneous bilateral hip replacement surgery performed?

Bilateral hip replacement is a significant procedure and is not a first-line treatment for joint diseases. When a patient shows no response to medications, less complicated surgical procedures, or rehabilitation, then it is recommended to perform a simultaneous bilateral hip replacement. Some of the conditions in which hip replacement procedure is performed are as follows:

Severe Osteoarthritis
Rheumatoid Arthritis
Post-Traumatic Arthritis
Avascular Necrosis
Congenital Hip Dysplasia
Ankylosing Spondylitis
Slipped Capital Femoral Epiphysis
Paget's Disease
Hip Fractures
Chronic Hip Pain
Hip Joint Infections
Developmental Dysplasia of the Hip
Perthes Disease
Inflammatory Arthritis
Tumors affecting the hip
Failed Previous Hip Surgery
Bilateral Hip Impingement

How long is recovery from a bilateral hip replacement?

Recovery after bilateral hip replacement is the same as a single hip replacement procedure, and both hips recover in time of a single hip replacement. The recovery from bilateral hip replacement involves the following:

After the procedure, patients usually spend a few days in the hospital for observation. During this recovery phase, medications are given to the patient to prevent complications such as pain, bleeding, infection, blood clot formation, etc.
On the same day after surgery or 2-3 days after surgery, the physiotherapist guides the patient to start walking with assistance, such as a walker.
After discharge, patients continue a physical therapy program at home for several weeks to strengthen their hips and improve their range of motion.
Physical therapy exercise intensity gradually increases to put workload on joints and muscles around them.
After 10-12 weeks, the patient recovers completely and can resume daily activities without restriction.

What complications are possible from a simultaneous bilateral hip replacement?

Like any other surgery, simultaneous bilateral hip replacement also has some chances of side effects and complications. Luckily, advanced technology and techniques can help overcome these complications, which may include:

Infection
Blood clots (deep vein thrombosis)
Pulmonary embolism
Implant dislocation
Nerve injury
Blood loss requiring transfusion
Fractures around the implant
Implant loosening or wear
Leg length discrepancy
Joint stiffness
Chronic pain
Allergic reaction to implant materials
Heterotopic ossification
Cardiovascular complications
Urinary tract infection
Pneumonia
Wound healing problems
Fat embolism

Conclusion

A bilateral hip replacement procedure is a medical procedure in which both diseased hip joints are treated and replaced with an artificial hip at the same time to avoid complications like double anesthesia administration, significant blood loss, and double hospital stays.