bilateral hip replacements

[donna]

Does any one have any information on the contraindications to bilateral hip replacements that are different to single hip replacements. I have a couple of yonger patients that are asking about intercourse positions and sporting activites once they have their new hips.

[sven]

Title
One- or two-stage bilateral total hip replacement.
Author
Alfaro Adrián J; Bayona F; Rech JA; Murray DW
Address
Nuffield Orthopaedic Centre, Oxford, United Kingdom.
Source
J Arthroplasty, 1999 Jun, 14:4, 439-45
Abstract
It is not clear whether bilateral hip replacement should be done in 1 or 2 stages. The total number of total hip replacements (THRs) done in our center between 1989 and 1995 was approximately 4,000. ......Our results demonstrate that, in our patient population, bilateral THR was equally safe whether performed as a 1-stage or 2-stage procedure. This was the case in the low-risk (ASA 1 and 2) and high-risk (ASA 3 and 4) patient subgroups. One-stage bilateral THR is cheaper and involves less time in the hospital.



Title
Immediate weightbearing after uncemented total hip arthroplasty.
Author
Rao RR; Sharkey PF; Hozack WJ; Eng K; Rothman RH
Address
Rothman Institute, Philadelphia, PA 19107, USA.
Source
Clin Orthop, 1998 Apr, :349, 156-62
Abstract
Radiographic subsidence of the femoral prosthesis and clinical results after unilateral and simultaneous bilateral uncemented total hip arthroplasty were compared. Patients who had bilateral total hip arthroplasty began weight-bearing as tolerated on both lower extremities the day after surgery. Patients who had undergone unilateral total hip arthroplasty were maintained at 10% weightbearing on the operative limb for 6 weeks after surgery. Patients in both groups were matched for age, gender, and weight. Minimal followup was 2 years. There was no difference between the two groups in terms of clinical results. Radiographic assessments were performed immediately after surgery, 6 weeks after surgery, and again at 2 years after surgery......At the 2-year followup, all femoral prostheses in both groups appeared radiographically stable with evidence of bone ingrowth and no indications of loosening. Thus, immediate weightbearing after bilateral total hip arthroplasty in this study resulted in more initial subsidence (during the first 6 weeks after surgery) of the femoral prosthesis but did not preclude the prosthesis from becoming stable and achieving bone ingrowth. Patients in both groups obtained satisfactory clinical results. Because initial stability and bone ingrowth are factors influenced by prosthesis design, the results of this study may not be applicable to all implants.
I found this info on medline/ healthstar trough the physiobase library. It works real well guys, thanks
Sven