It Takes Two: Replacing Knee or Hip Joints in
One Fell Swoop
by Jonathan P. Garino, MD
If arthritis in your knees or hips makes it
painful to take even a few steps, you may be thinking
about joint replacement surgery.
If you decide to have joint replacement surgery,
the next question is: Should you have surgery
on both joints simultaneously – for example,
both knees or both hips replaced during one surgical
procedure - or have one joint replaced and then
have surgery on the other joint a year or so later?
It depends on the patient, but many times, I
recommend bilateral replacements, which means
replacing both of your knees or both hips at the
same time.
Why? There are three main factors.
First, to be considered for joint replacement
surgery, patients have to be deemed in good general
health. Every potential joint replacement surgery
patient undergoes a detailed medical evaluation
to determine if there are any significant health
issues that need to be reviewed or improved prior
to surgery. This minimizes complications during
surgery and optimizes the rehabilitation process
that follows. Patients who are given the green
light for joint replacement surgery are typically
healthy enough to withstand replacing both of
their knees or hips simultaneously.
The second factor is rehabilitation. Bilateral
surgery is preferred because it is best for your
knees or hips to rehabilitate simultaneously.
In recent years, orthopaedic specialists have
realized that progressing through the rehabilitation
process with one “new” joint and one
“old” joint proves awkward and uncomfortable
for patients. On the other hand, if both of your
knee joints are replaced at the same time, rehabilitation
of the newly-repaired joints is smoother and more
balanced. (Of course, if only one of your knees
or hips is damaged - from trauma, for example
- there is no need for bilateral joint replacement
surgery.)
The third consideration is pain. Many joint replacement
patients assume that having two joints replaced
at one time translates into twice the pain. However,
major advances in pain management, including patient-controlled
analgesia, minimize pain and keep patients comfortable
before, during, and after bilateral joint replacement
surgery. Although it typically takes six to 12
weeks for a full recovery, the majority of bilateral
joint replacement surgery patients find that they
ambulate quite comfortably after two or three
weeks.
If you decide to schedule joint replacement surgery
and wonder if it is preferable to have your hips
or knees replaced during the same operation, consider
these three factors, and then talk to your surgeon
to decide what it best for you.
 Jonathan
P. Garino, MD is a board-certified orthopaedic
surgeon and Director of the Joint Reconstruction
Center at the Penn Orthopaedic Institute at Penn Presbyterian Medical Center. He is the author
of several books used by practicing orthopaedic
surgeons throughout the world and was recognized
in Philadelphia Magazine’s 2002 Tops
Docs issue.
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