Double (Bilateral) Hip Replacement

Mr Dennis Kosuge is a Consultant Orthopaedic Surgeon with a specialist interest in hip replacement, offering treatment for patients across Essex and Hertfordshire at The Rivers Hospital, Sawbridgeworth. He sees patients from Bishop's Stortford, Harlow, Epping, Hertford and Hemel Hempstead. When severe arthritis affects both hips, Mr Kosuge can replace both in a single operation for suitable patients, meaning one admission, one anaesthetic and one recovery instead of two.

Frequently Asked Questions about double hip replacements

Do I need a double hip replacement?

What is a double hip replacement?

Simultaneous or staged: what is the difference?

How does Mr Kosuge approach double hip replacement?

Who is suitable for a double hip replacement?

How long does a double hip replacement operation take?

How long will I stay in hospital?

What is recovery like after a double hip replacement?

How long does a double hip replacement last?

What are the risks of a double hip replacement?

You may benefit from replacing both hips if severe arthritis in both is causing:

• persistent pain in both hips that is not controlled by painkillers, physiotherapy or injections

• pain at night or at rest

• stiffness that limits walking, stairs, putting on socks and shoes, or getting in and out of a car

• significant damage to both joints on X-ray

Often one hip is clearly worse than the other. If only one is truly troublesome, a single hip replacement is usually the right first step. The decision is always made together, after an honest discussion of the benefits and risks.

A double, or bilateral, hip replacement is the replacement of both hip joints. It can be done in one of two ways. In a simultaneous replacement, both hips are replaced during a single operation under one anaesthetic. In a staged replacement, the two hips are replaced in separate operations, usually at least three months apart. Both approaches are well established, and which is right depends on the individual patient.

When both hips are severely arthritic and both are causing significant symptoms, Mr Kosuge can replace both hips in the same operation, one after the other, under a single anaesthetic. He operates on the more painful or more severely affected hip first. Once that side is complete, the surgical and anaesthetic team reassess you together and only proceed with the second hip if it is safe to do so. If not, the second hip is replaced at a later date.

Replacing both hips at once is a bigger operation, so it is reserved for patients who are fit enough to cope with it. In general, that means:

• severe arthritis in both hips, with both causing significant pain or disability

• good general health, without significant heart or lung disease or a previous stroke

• no other major medical problems, such as poorly controlled diabetes or a high risk of bleeding

• the motivation, and the support at home, to manage rehabilitation with both hips recovering at once

Overall fitness matters more than age. Mr Kosuge assesses each patient individually with the anaesthetic team, and if doing both hips together is not the safer option, he will recommend replacing them in stages.

Each hip takes around 60 to 90 minutes to replace, so the operation takes roughly twice as long as a single hip replacement, plus a short pause between the two sides while the team reassesses and re-positions you. You will be away from the ward for longer than you would for a single hip.

Most patients stay one to two nights longer than they would after a single hip replacement. Going home on the same day is not usually appropriate after a double hip replacement. You will go home once you are walking safely with walking aids, can manage stairs and the physiotherapists are happy with your progress.

Most patients are up and walking with a frame on the day of surgery. Because both hips are recovering at once, the first few weeks are harder than after a single hip, and you will rely more on walking aids and help at home. Physiotherapy continues for several weeks. Full recovery usually takes three to six months, much as it does after a single hip replacement, but you go through one recovery instead of two.

Each hip is a standard hip replacement, so each is expected to last as long as a single one. For most people that is more than 20 years, based on National Joint Registry data.

The risks are the same as for a single hip replacement, including infection, blood clots, dislocation and nerve injury, all of which are uncommon. Because more surgery is done in one sitting, there is more blood loss and greater strain on the heart and lungs, and a blood transfusion is more likely. This is why careful patient selection matters, and why Mr Kosuge will not recommend doing both hips at once unless he judges it safe for you. All of the risks are discussed fully at your consultation.

More Frequently Asked Questions:

Book a Consultation

If arthritis is affecting both of your hips and you would like to know whether a double hip replacement is right for you, Mr Kosuge will examine you, review your imaging and explain honestly whether to replace both hips together or in stages. Mr Kosuge offers private consultations at The Rivers Hospital, High Wych Road, Sawbridgeworth, CM21 0HH.

To book an appointment, please call 01279 602675 or use the online booking link below.

NHS referrals to The Princess Alexandra Hospital, Harlow are also accepted via your GP.