Should You Replace Both Hip Joints at Once? Insights on Surgery and Insurance

Hip joint surgery issues?

Hello, I have severe wear in both of my hip joints, and my doctors have recommended a hip replacement.
However, due to work-related reasons, I would like to have both sides replaced at the same time.
The doctors informed me that due to the health insurance system, I can only replace one side at a time.
Could you advise me on whether it is recommended to replace both hip joints simultaneously? Does health insurance only cover the cost for one side in a single surgery?

Leon, 40~49 year old female. Ask Date: 2018/08/21

Dr. Shi Guozheng reply Orthopedics

When both sides are operated on simultaneously, the physician will assess the patient's condition to determine whether it is appropriate to administer anesthesia and perform surgery on both sides at the same time.
There are benefits to simultaneous surgery on both sides, but there are also risks involved.

Reply Date: 2018/08/21

More Info

When considering whether to replace both hip joints simultaneously, there are several factors to weigh, including the potential benefits, risks, and insurance coverage.

Benefits of Simultaneous Hip Replacement
1. Reduced Recovery Time: One of the primary advantages of undergoing bilateral hip replacement (replacing both hips at the same time) is that it can significantly reduce the overall recovery time. Patients only need to go through one surgical procedure, one hospital stay, and one rehabilitation period, which can be more efficient than having two separate surgeries.

2. Improved Mobility: For patients with severe bilateral hip osteoarthritis, having both joints replaced at once can lead to a more immediate improvement in mobility and quality of life. Patients often report a quicker return to normal activities, as they are not waiting for one hip to heal before addressing the other.

3. Cost-Effectiveness: Although the upfront costs may seem higher, having one surgery instead of two can be more cost-effective in the long run. This includes savings on hospital stays, anesthesia, and rehabilitation services.

Risks of Simultaneous Hip Replacement
1. Increased Surgical Risk: Performing bilateral hip replacements increases the complexity of the surgery and the duration of the procedure. This can lead to higher risks of complications such as blood loss, infection, and thromboembolic events (like deep vein thrombosis or pulmonary embolism).

2. Longer Anesthesia Time: The longer the surgery, the longer the patient is under anesthesia, which can increase the risk of complications related to anesthesia.

3. Rehabilitation Challenges: While some patients may benefit from quicker recovery, others may find the rehabilitation process more challenging when both hips are replaced at once. It may be more difficult to regain strength and mobility without the ability to rely on one leg during recovery.

Insurance Considerations
Regarding insurance coverage, it is essential to understand the specific policies of your health insurance provider. In many cases, insurance may only cover one hip replacement at a time, especially if the procedure is deemed elective. This is often due to the increased risks and costs associated with simultaneous surgeries.
However, some insurance plans may allow for bilateral procedures if there is a clear medical necessity and if the surgeon can justify the need for both hips to be replaced at the same time. It is advisable to discuss this with your healthcare provider and insurance representative to understand your options fully.

Conclusion
In summary, whether to proceed with simultaneous hip replacements should be a decision made in consultation with your orthopedic surgeon, taking into account your specific medical condition, overall health, and personal circumstances. While there are benefits to having both hips replaced at once, the risks and insurance limitations must also be considered. If your surgeon believes that you are a good candidate for bilateral replacement and can manage the associated risks, it may be a viable option. Always ensure that you have a thorough discussion with your healthcare team to make the most informed decision possible.

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