**Abstract**

Osteoarthrosis is the most common chronic joint condition, the aetiology of which is still not completely clear. Initial phases of disease are treated conservatively applying physical rehabilitation procedures and medications. Advanced stages need surgical treatment with numerous procedures, depending on the joint affected. Joint arthroplasties are procedure of choice, especially for big joints of the extremities. As osteoarthrosis occurs bilaterally very frequently, there are a growing number of patients in need for operation of both joints. Those procedures can be performed under single anaesthesia or staged procedure, with delay between two surgeries. There are many advantages and disadvantages of both approaches cited by different authors. There is consensus of authors in available articles regarding benefits of single-stage procedure: lower cost, shorter hospital stay, single rehabilitation period and better functional results. Authors disagree about safety of a single-stage bilateral procedure as well as incidence of complications and criteria for selection of patients for safe performing of simultaneous procedure.

**Keywords:** osteoarthrosis, hip, knee, bilateral, simultaneous

## **1. Introduction**

Osteoarthrosis is the most common joint disease in humans [1]. The American College of Rheumatology defines it as a heterogeneous group of joint affections that lead to occurrence of joint symptoms and signs related to damage of joint cartilage integrity, accompanied by changes in subchondral bone and surrounding soft tissues. Aetiology of osteoarthrosis remains only partially known for the time being. It is considered to have multifactorial causes, and its occurrence is a final result of interaction of systemic factors (older age, increased body weight, etc.) as well as local risk factors (mechanical load, injuries, etc.).

Osteoarthrosis can be treated both conservatively and surgically. Conservative treatment options can be divided into pharmacological and non-pharmacological. Those two treatment modalities tend to be combined aiming at achieving best possible results.

Pharmacological therapy includes the use of analgesics, NSAID, corticosteroids, oral drugs based on glucosamine and hyaluronic acid as well as intra-articular injections of sodium hyaluronate and corticosteroids. All the abovementioned therapy

modalities have very different results as explained in available reference literature. In the past decade or so, there has been a growing trend of regenerative procedures involving application of platelet-rich plasma (PRP) and stem cell therapy.

Non-pharmacological options include education of patients, reduction of body weight, exercises for muscle strengthening and stretching in order to prevent contractures, application of orthosis as well as different forms of physical rehabilitation.
