It’s not uncommon for patients with knee or hip arthritis to have bilateral disease, meaning that both hips or both knees are affected. In many patients however, one side is generally more painful than the other. For these patients, I generally recommend single or staged joint replacement, addressing the most painful side first. Typical recovery is 2-3 months after joint replacement. If possible, it’s best to allow the new replacement to fully heal prior to proceeding with the other knee or hip. At that time, the opposite joint will be evaluated and if still painful, it’s generally acceptable to proceed. Many of my patient’s procedures end up being staged 2-3 months apart.
Occasionally, patients will present with severe bilateral knee or hip arthritis. If both joints are affected equally and cause similar disability, I will consider staged joint replacement 6 weeks apart or even simultaneous joint replacement. These patients have to be low risk with minimal pre-operative medical conditions. They also would require adequate social assistance or at-home care to facilitate their recovery.
In general, I recommend the staged approach to my patients as we are able to manage pain better with single procedures and I believe patients seem to recover better when they’re focused on one joint at a time.
Written by Dr. Thomas Aleto who received remuneration as a Zimmer Biomet consultant for writing this article