When hip and knee both need to be replaced, hip surgery usually done first

. October 25, 2019.
hip-replacement

Tribune Content Agency

DEAR MAYO CLINIC: I need a total hip replacement and a total knee replacement – both on my left side. Does it matter which procedure is done first? How soon after one procedure can I have the other procedure done?

ANSWER: In a situation like yours, it’s typically recommended that the joint causing the most symptoms be replaced first. If symptoms are similar, then it’s usually best for the hip replacement to be done first. You’ll need to allow about six weeks for recovery and rehabilitation after your hip replacement. Depending on your individual circumstances, you should be able to move forward with the knee replacement procedure any time after that.

Joint replacement involves removing parts of an arthritic or damaged joint, and replacing them with metal, plastic or ceramic components that replicate the movements of a healthy joint. The surgeries you’re considering are the most common total joint replacement procedures done in the U.S. About 700,000 knee replacements and about 400,000 hip replacements are performed in the U.S. each year.

Hip replacement surgery is a slightly more straightforward procedure than knee replacement. That’s because the hip is a basic ball-and-socket joint. Therefore, it’s a fairly straightforward process to create and implant parts to replace that joint effectively. In contrast, the knee is a complex joint that allows for a wider range of motion and more flexibility. While the knee joint can be replaced successfully, the technique to do so may be more complicated and generally requires a longer recovery after surgery than the hip.

The difference in surgical complexity is one of the reasons hip replacement usually is recommended before knee replacement. Another is that chronic hip pain can cause pain in other parts of the body, too, including the knees. This is called “referred pain.” So, in some cases, replacing the hip may decrease pain in the knee – possibly reducing it to a point that it could be managed with nonsurgical treatment, such as physical therapy, thereby making a knee replacement unnecessary.

Performing a hip replacement before a knee replacement also is preferable due to the rehabilitation that’s involved. For hip replacement, recovery and rehabilitation generally takes about six weeks. Regular activity and exercise, as directed by a physical therapist, can help that process. Although you may need to make some adjustments, having a painful knee usually doesn’t disrupt the rehabilitation needed after hip replacement. For knee replacement, full recovery often takes considerably longer than hip replacement. And having a painful hip can interfere with the rehabilitation necessary following a knee replacement.

Both hip and knee replacements have high rates of success when performed well by experienced surgeons. The implants used in joint replacements are durable, often lasting for decades. In people who receive a total hip replacement, about 90 to 95 percent receive almost total relief of pain following the surgery. Because of the intricacy of the joint, that number drops slightly for knee replacement to about 80 to 85 percent.

Complication rates are similar for hip and knee replacements. Although the risk is low, infection is a possibility following both of these procedures. Complete dislocation is not a risk with the knee, but it can be problem with the hip joint after replacement. Knee joints, on the other hand, can be susceptible to instability after surgery if the ligaments aren’t tensioned properly. Working with a surgeon who has expertise and experience in joint replacement can decrease the likelihood of these complications.

The specific amount of time required between joint replacement surgeries depends on your symptoms, medical history and other health conditions you may have, along with how well your overall recovery and rehabilitation progress and any complications you experience. Talk to your orthopedic surgeon about your situation to decide on the timeline that’s right for you. – Robert Trousdale, M.D., Orthopedic Surgery, Mayo Clinic, Rochester, Minn.

Trending

MSTORYTELLING: Visiting Gigi’s house

  A first time grandma reflects on the changes a baby brings to holiday family gatherings  By Lisa Alleman Thanksgiving 2018.  We gather around my dining room table to eat our turkey dinner with urgency. Unlike other years, the turkey is not the main event. My daughter, who is 5 months pregnant with our first

Thanksgiving Day Roundup 2020: All the Good Eats, None of the Hassle

Photo by Element5 Digital on Unsplash We all know that cooking your own Thanksgiving dinner can be a bit stressful at times. Luckily, there are other options for both dine-in and pick-up if you want to skip the laborious work and relax with your family and friends. We’ve put together a list of some of

Quarantined and Disconnected: COVID-19’s effects on those with disabilities

Senior citizens and others with conditions that render them especially susceptible to COVID-19 aren’t just struggling because of the potential for contracting the virus — the isolation from months of lost social interaction has been devastating for many. Assisted living facilities, highly regulated, controlled environments when it comes to social isolation, finally allowed visitation with

HELPING OLDER ADULTS AVOID ISOLATION AND LONELINESS 

As winter sets in, isolation increases for older adults, but there are ways to limit loneliness.  In a year that has been defined by isolation, loneliness may increase in the next few months as flu season, cold weather and a possible uptick in COVID-19 become the norm.  It seems likely that many holiday activities will