Most of the people who undergo knee or hip replacement surgery have the procedure done on just one side. This choice has to do with the fact that their symptoms usually pain, stiffness and limited mobility are mostly one sided. There are some people who have degenerative problems in both hips and they face serious problems in both joints with their surgeons guidance can consider having both the hips replaces at the same time. This is called as bilateral total hip replacement. It may also be referred to as simultaneous total hip replacement.
Hip dysplasia is considered to be a multifactorial condition which means that several factors are involved in causing the condition to manifest.
Its cause is unknown but it is common in cases of a large fetus or a fetus in a breech position.
- Congenital- A genetic factor is indicated since the trait runs in families and there is an increased occurrence in ethnic populations.
- It has been often linked to traditions of swaddling of infants or use of overly restrictive baby seats, carriers and other methods of transporting babies or use of cradle board which locks the hip joint in an adducted position (Pulling the knees together which tends to pull the heads of the femur bone out of the sockets or acetabulae) for extended periods.
- Further risk factors include breech birth, gender, genetics and first borns.In breech position the femoral head tens to get pushed out of the socket. A narrow uterus also facilitates hip joint dislocation during fetal development and birth.
- Before bilateral hip surgery you may be given a spinal anesthetic which will knock out all feeling below your waist during your operation. Sedative could also be given which would help you relax or even sleep during the surgery.
- The surgeon will make three to six inch incision over your hip to expose the deeper tissues.
- Damaged bone and cartilage in the socket are removed and the socket is smoothed and enlarged slightly to receive the artificial metal shell implant. At times a screw is used to enhance fixation. A highly polished socket liner made if polyethylene plastic metal or ceramic is then secured inside the socket shell.
- The surgeon will create a narrow channel about five inches long into the top of your thigh bone (femur)to receive the stem and ball of your new implant. This part of the device is secured in place with or without cement. If bone cement is not used the materials of the stem will be made of a rough porous titanium alloy that allows your natural bone to grow into it and help stabilize it.
- The materials in your new ball and socket joint press against one another easily to help restore motion in your hip.
- The length of the operation may range from one to two hours.
How it Works?
The advantage of bilateral hip replacement surgery includes one trip to the operating room instead of two, one anesthetic and therefore one hospitalization.
Usually people do not spend more than 3-5 days in the hospital after hip replacement surgery. Patients who are employed may find that they need less time off from work overall than it they were to recover from two replacements on two different occasions.
Full recovery of the surgery takes about 3-6 months depending on the type of surgery, your overall health and the success of your rehabilitation.
- People who had undergone the surgery for both the hips at the same time take longer time to recover than those who have surgery for just one hip. The amount of time to spend in a rehabilitation hospital setting would be more.
- There has to be regular follow up visits with the surgeon to check on how the progress is going on. You have to visit the surgeon as per his recommendations.
Risks can be increased however as the surgical blood loss is greater and the surgery as well as the anesthesia are more prolonged two to four hours as opposed to one to two hours for a single hip.
Hip replacement surgery involves both short and long term risks which are as follows.
Short term risks
Dislocation of the new prosthesis which might occur in the first 10-12 weeks after surgery.
- Deep Vein Thrombosis (DVT) .There is some risk of a clot developing in the deep vein of the leg after hip replacement surgery because of the blood supply to the leg is cut off by tourniquet during the operation.
- Infection-The risk of infection is minimized by storing autologous blood for transfusion and administering intravenous antibiotics after surgery. Infections occur in less than 1% of hip replacement operations.
- Injury to the nerves that govern sensation in the leg. This problem usually revolves over time.
Long term risks
- Inflammation related to wear and tear on the prosthesis: Tiny particles of the debris from the prosthesis can cause inflammation in the hip joint and lead eventually to dissolution and loss of bone. This condition is known as Osteolysis.
- Heterotopic bone: Heterotopic bone is bone that develops in the space between the femur and the pelvis after hip replacement surgery. It can cause stiffness and pain and may have to be removed surgically.
- Changed length of leg- Some patients find that the operated leg remains slightly longer than usual than the other leg even after recovery. This problem will not interfere with mobility and can usually be helped by an orthotic shoe insert.
- Loosening or damage to the prosthesis itself. This development is treated with revision surgery
India offers outstanding medical care at approximately 10 to 30 percent of the cost of the US based health care. It would be difficult to discover any other medical system this cost effective elsewhere in the world.
Bilateral Hip replacements India is at low cost with international standards of care and quality is made possible by medical tourism companies. India has a panel of best hospitals for hip replacement surgery in India equipped with the latest medical technology.
- Most people who have bilateral hip arthroplasty should expect to spend time in a rehabilitation hospital after being discharged from the acute care hospital
- There should at least be six week off from your work after the surgery depending on the physical demands of your profession.
The risk for post operate blood clot tends to be slightly higher for people undergoing bilateral hip replacement
s surgery than it is for those having surgery on just one hip.