Guidelines for Multiple Joint Replacements

If your doctor is recommending you have joint replacement surgery for more than one joint, you may be wondering what is the best course of action. Can more than one joint be replaced during the same surgical procedure? And what are the benefits, concerns and recovery time associated with single versus multiple joint replacement surgeries.

Below we’ve outlined factors you and your doctor will consider. Together you’ll decide the best approach for replacing your joints.

Why Replace Multiple Joints?

Some people who need joint replacement surgery only have degeneration or arthritis in one joint. For them, a single surgery may be the only treatment they need.

Other patients, especially those with arthritis, have pain in several joints. Arthritis can attack both knees, your shoulder and hip, etc. In this case, you may need to replace multiple joints.

Bilateral Joint Replacement

If you need a pair of joints replaced, like both knees or hips, one option is replacing both in a single, longer surgery. This is known as bilateral joint replacement, or a double knee or hip replacement.

Advantages include:

• One surgery requires only one round of anesthesia, one recovery and one course of rehabilitation.
• You may miss less work with only one surgery and recovery (versus multiple leaves).

Separate Surgeries

Another option is to stagger your surgeries. You’ll have separate procedures at least three months apart.

Advantages include:

• Replacing one joint in a shorter surgery means you won’t be under anesthesia as long. You may also have less blood loss, reducing your risk of needing a blood transfusion.
• While multiple surgeries mean multiple recoveries, your recovery after each surgery may be shorter and less painful.

Extra Considerations

You and your doctor will discuss whether you are an ideal candidate for one surgery or you’ll need multiple surgeries. Your age, weight, health conditions, pain tolerance and which joints need replacement will all be considered. Other factors include:

• A single surgery may be best if you’re having a pair of joints replaced (both knees or hips).
• If you need a shoulder and hip replacement, your doctor will probably replace the shoulder first. It will need time to heal so you can use crutches or a walker after hip replacement.
• If you need your hip and knee replaced on the same leg, your doctor may replace the hip first. Hip pain often shoots down to the knee, and once your hip heals you may realize your knee pain was not caused by arthritis. Even if your knee pain continues, it’s less likely to interfere with rehab after hip surgery. Alternately, hip pain can make recovery from knee surgery difficult.

No matter what plan you choose, we’ll make sure you understand the benefits and risks. We’ll also make sure you know what to expect during and after the procedure, including rehabilitation and recovery.