Single vs. Double Hip Surgery

[Van A.]

I have found a surgeon I like and trust but he told me he has never done a bilateral hip replacement and doesn't recommend it for two main reasons.

1. More blood is lost during a bilateral operation (I forgot to ask how much more).
2. The surgical instruments are not resterilized after the 1st hip replacement and therefore the risk of infection increases from about 1% to 4-5%.

He does the MIS one incision anterior surgery and does use a specially designed surgical hip replacement table to aid in the operation but not the hana table I have read about. He expects me to be walking ***isted the same day. Then home two days later and able to walk un***isted and without much, if any, pain. His fee for doing the operation is $1450 which I think is reasonable if not low. (By the way, does anyone know a ballpark figure for what the total cost of the surgery is?)

His recommendation is to come back after the 1st operation in three months and have the second hip replaced. He expects the same results with the 2nd hip operation. Is this sound advice? I ***ume the cost of doing two operations will be twice what it would be to do one and I have to undergo two operations instead of getting both hips replaced in one fell swoop. I welcome any comments.

 

[ripanco]

Hi Van,

Where are you located? Your post makes me think you may not be in the USA.

First of all, if the surgeon has NEVER done simultaneous bilateral THR, I sure would not want to be his first! As for his reasons, who knows.

I had simultaneous bilateral THR in May '05. Extremly succesful. I did not need any blood and my surgeon never mentioned anything about an increased risk of infection and given how meticulous his is, I believe he would have told us if it there was any increased risk. However, my OS did have some pretty strict guidelines for the surgery. His criteria are the patient must be lean, strong, young, motivated, good bone, and good home support.

For me there were no drawbacks in having simultaneous, only positive results. One surgery, one recovery, both legs healing at the same time/rate. The surgery is of course longer and second hip did prove to be in pretty bad shape so the surgery took longer than expected, about 4.5 hrs. But I was up the next morning, cruising the halls with crutches by afternoon (and stairs) and home the following morning. My recovery was very swift, back to most my life and athletic endevors within a few months or less.

As to the cost, I am not completly sure since insuranced covered most, but it was WAY more than you were quoted! More like $25,000/hip. It is less with just one surgery, I am thinking mine was about $32,000. Even if the quote you got was just for the OS's fee, I think that is really, really low, but I may be completly wrong on that too! My OS's is connected with the hospital so the bill was not seperated, at least I did not see that part, sure the insurance co. did.

Whch ever way you go, you are going to love your new hips! Good luck,

Andrea
Believe In Barbaro

 

[Van A.]

I am in Texas. This surgeon may not think two operations are any major inconvenience to me. He tells me actual surgery time will be one hour, I will be walking the same day and home the next day with two weeks to full activity/stamina, including playing tennis. Because of the anterior approach the hip is firmly implanted iimmediately after the operation is completed.

I know the surgeon's fee is accurate because I have already paid my 10%. I called the hospital but all they will tell me is that I will have to pay a $250 deductible and they will be bill me for my 10% co-pay when all costs are calculated.

It does seem that getting both hips replaced at the same time would be the most efficient way to proceed but I do like and trust this guy. Maybe this surgeon has never seen the need to replace both hips at the same time and just thinks it is easier on the patient to have one hip replaced, then three months later, the other. I don't know...

 

[Annemarie]

Greetings. Now that both my hips are securely set, one is now 9 months new and the other 5 months new I am ready to make up for lost time, the time (about 15 years) lost due to dibilitating hip pain. I am truly amazed that such major procedures as sawing apart the two major bones in ones body can result in such marvellous recouperation. I am walking fine, both legs remained the same lenght. I do however, on occasions, use my cane. I have a tendency to limp after prolonged sitting, I feel sort of cramped, or when too much walking has tired the hips. A cane prevents the limp, and I do wish to walk as perfect as I can. I am glad it is all over and all has healed so well. Even the long scars have faded greatly. To all of you out there in need of hip surgery, don't wait too long, it is all worth it once you are past the first week or two post op.

 

[ripanco]

Congratulations on your new hips and new life, Annemarie!! Glad to hear all went well and you are well on your way to full recovery. I found that even after a year, I was still getting a little better with more time.
Take care,

Andrea
Believe In Barbaro

 

[peg]

What questions should I ask my physician to find out if he is the right one for my operation? I'm 79 years old, I think in good condition. I'm terrified of infections. How do I find out the infection rates in different hospitals? I'd appreciate any input.

 

[Annemarie]

Hello peg. Ask your surgeon if it is ok to have dental work within to years of your operation. I have heard that dentists will first treat you with antibiotics prior to doing any dental work for fear of possible infections which could ultimatly harm body and implant. Also watch out for cuts while taking blood thinners. I had a small papercut which actually resulted in rather profuse bleeding with drops hitting the floor on the way to the first aid box.

 

[peg]

Annemarie,...thanks for your input. When you talk about dental work, do you mean something beyond simple cleaning? I can't wait two years before I have this operation. I'm in constant pain. I will be scheduling my operation very soon. I'm encouraged to learn that you've had two hips done...I suspect that's what I'll be needing. Your operations were 4 months apart?

 

[Annemarie]

Greetings peg. It is true that infection can result from any "broken skin" type wound, bleeding during any dental work, teeth cleaning included. It is for that reason that your dentist should be made aware of your hip replacement prior to any dental work. Yes my second hip was replaced 4 months after the first one, I was 65 at that time (April 11 & Aug 15 2006). All went well and I walk absolutely normal again. Good luck to you.

 

[peg]

Thanks, Annemarie, your answer helped me to feel less apprehensive about going into surgery. I'm 79, but I think I'll be OK. I do fear infection post-op, but I haven't seen a post on that so far. I hope that is good news.

Peg

 

[Sonia S.]

Hello Annemarie, how are you? I see your doing well. I'm having ceramic-on-ceramic simultaneous bilateral THR posterior approach with large ball. The op is on tuesday 6th march. I am scared but have been re***ured that is will be OK. So, the days are approaching very fast. I will be back chatting in a couple of weeks. Best wishes to all. Sonia

 

[Sonia S.]

I have found a surgeon I like and trust but he told me he has never done a bilateral hip replacement and doesn't recommend it for two main reasons.

1. More blood is lost during a bilateral operation (I forgot to ask how much more).
2. The surgical instruments are not resterilized after the 1st hip replacement and therefore the risk of infection increases from about 1% to 4-5%.

He does the MIS one incision anterior surgery and does use a specially designed surgical hip replacement table to aid in the operation but not the hana table I have read about. He expects me to be walking ***isted the same day. Then home two days later and able to walk un***isted and without much, if any, pain. His fee for doing the operation is $1450 which I think is reasonable if not low. (By the way, does anyone know a ballpark figure for what the total cost of the surgery is?)

His recommendation is to come back after the 1st operation in three months and have the second hip replaced. He expects the same results with the 2nd hip operation. Is this sound advice? I ***ume the cost of doing two operations will be twice what it would be to do one and I have to undergo two operations instead of getting both hips replaced in one fell swoop. I welcome any comments.

Hello there, i'm 42 yrs old. I will be having ceramic-on-ceramic simultaneous bilateral THR on the 6th of March. It took a long time for me to convince myself that i needed this op. I really thought that i could grow old with aches and pain. But it reached to a stage where my body tells me something is very wrong, do something! So i finally made the appointment. I saw 3 surgeons, young surgeon, midlle age surgeon and an experienced surgeon. The funny thing is that they all said exactly the same thing. They told me that in my case it is best if i opted for simultaneous THR. I going for the most experienced. He charges an arm and a leg but if the job is done well then it is worth it. I will be back posting in a couple of weeks. Take care and best wishes, Sonia.

 

[Annemarie]

Hello Sonia. Good to hear that you are finally on your way of pain reduction. Ceramic on ceramic seems to be the preferred choice these days. I feel so much better since I had my two ceramic implants. All the best for the big day, my thoughts will be with you.

 

[Annette]

Hi Sonia,
I just want you to know my thoughts and prayers are with you.
For some time you've offered help to many, myself included, in this forum.
I'm set for THR on my birthday, March 26. I'll need both hips replaced but one at a time.
Best of luck.
Annette

 

[dixieodoodles]

He does the MIS one incision anterior surgery and does use a specially designed surgical hip replacement table to aid in the operation but not the hana table I have read about. He expects me to be walking ***isted the same day. Then home two days later and able to walk un***isted and without much, if any, pain. His fee for doing the operation is $1450 which I think is reasonable if not low. (By the way, does anyone know a ballpark figure for what the total cost of the surgery is?)

Don't know if you still need advice, but none of this sounds right to me. When I had a hip replaced back in 1988 the prosthesis alone cost $6000. I know because I looked over the bill.

With all the anesthesia in you, how could you possibly be up walking the same day? And what does 'un***isted' mean? You will surely need a walker or crutches.

I also don't know why he would run out of blood or not have enough sterilized instruments available.

This all just doesn't make sense to me.

 

[JGosse]

Just a thought. If Van A. thinks he is going to be palying tennis two weeks after surgery he needs to get some better information. In two weeks you can expect to be walking pretty well if you have the "glued" method, but there's no way you will be stable enough to play tennis. The risk of a fall would be very high. The muscles that are cut for this surgery have to heal.

 

[Annemarie]

There is absolutely no way that anyone should play tennis or do any other over-active activities until the surgeon has given the OK. Lets face it, all that cut tissue, muscles, veines etc. and severed major bones must first heal properly in order to support the entire human frame before one should be jumping about. I suspect that once post op X-rays reveal healing the surgeon will advise the patient as to his range of permitted motion. I am very happy with both my non cemented ceramic on ceramic hips and scars well healed but would not wish to repeat the ops due to some self inflicted damage.

 

[Josephine]

Just a thought. If Van A. thinks he is going to be palying tennis two weeks after surgery he needs to get some better information. In two weeks you can expect to be walking pretty well if you have the "glued" method, but there's no way you will be stable enough to play tennis. The risk of a fall would be very high. The muscles that are cut for this surgery have to heal.

I had to chuckle when I read your post, Gosse. The post to which you refered was over one year old! I suspect the Van A has had his hip done and forgotten about it by now!

But for the record, the risk is not to do with the healing of the muscles or the incision, but to do with the healing of the bone and the settling of the prosthesis into the bone or the cement into the bone. Any jarring in the early stages can cause the beginnings of loosening which may not show up until some months later.