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What happens if I need both a hip and a knee replacement?

As Americans live longer, arthritis becomes a more and more common infirmity. In a great many cases, the joints affected are the hips and knees. The American Association of Hip and Knee Surgeons (AAHKS) estimates that in less than 15 years, there may be a need for 500,000 hip replacements and 3,000,000 knee replacements among the American population. Serious consideration and consultation with a skilled orthopedic surgeon is necessary for any joint replacement. For patients who require both hip and knee replacements, it is essential that a knowledgeable orthopedic surgeon who specializes in surgeries of these particular joints be consulted.

Which surgery should be performed first?

If you need replacements of both a hip and a knee, one of the concerns is how well you will tolerate rehabilitation. Most orthopedic surgeons recommend that you have the replacement hip implanted first. This is because hip surgery requires less rehab so patient and doctor can estimate how well you may do with knee surgery recovery once you have a track record of rehab from your hip surgery.

In cases where both knees and both hips need replacement, doctors don’t always agree about how to proceed. Some surgeons recommend operations of both knees, or both hips, at the same time during the same surgery. Others recommend having two separate surgeries performed during the same hospital stay.

Reasons for Decisions Regarding Sequence of Surgeries

In cases where you need hip and knee replacement on the same leg, doctors usually operate on the hip first, or on the joint that is more painful. The two reasons for this are that:

Arthritic pain can spread as referred pain from the hip joint to the knee. By replacing the hip joint first, you will have more clarity after hip surgery how much of the knee pain you’ve been experiencing has been referred from the hip.

When hip surgery is performed first, the pain the patient continues to experience in the knee will not interfere greatly with successfully completing rehabilitation. On the other hand, if you have a painful hip after knee surgery, you may have trouble completing rehabilitation for your knee. If you do have two surgeries at the same time or very close together, your recovery will take longer than if you had a single surgery. Still, it is likely to be shorter than the total recovery period for one surgery and recovery followed another.

The Good News about Hip and Knee Replacements

While no one likes to contemplate undergoing surgery, particularly when two or more operations are involved, the prospect of living without the severe, disabling pain of arthritis, and the accompanying physical limitations and emotional stress, often makes patients eager for relief. The encouraging reality is that hip and knee replacements are extremely successful surgeries. Although recovery takes time (more time for multiple operations) you can look forward to returning to a more active, pain-free existence after joint replacements. Not only will you experience improvement in your overall health, you will enjoy a greatly improved quality of life.

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