**2. Surgical treatment of osteoarthrosis**

#### **2.1 Osteotomies of affected joint(s)**

With the development of new materials and new surgical techniques, arthroplasties of joints have become a primary solution in surgical treatment of osteoarthrosis. However, there are still certain indications for osteotomies, especially for osteoarthrosis of lower leg big joints among young adults, aiming to postpone a total joint arthroplasty. Some studies show that at least 40% of patients with performed osteotomies need a total joint arthroplasty only a few years later [2, 3].

#### **2.2 Arthrodesis**

Arthrodesis is a surgical fusion of joints. Nowadays it is rarely performed in big joints, mostly as salvage procedure for treating infection after failed arthroplasty. Arthrodesis is more frequently used in treating osteoarthrosis of small joints in the foot.

#### **2.3 Joint arthroplasties**

At this moment, joint arthroplasties are the most preferred solution for degenerative changes in big joints, especially the knees, hips and shoulders. There are numerous reports of arthroplasties of these three joints in last few decades, showing excellent functional results and patient satisfaction. As about elbows, ankles, and small joints of the hands and feet, reported arthroplasty outcomes are still not comparable with those in the hips, knees and shoulders.

There are many different forms of joint arthroplasties regarding types of fixation, articular surfaces and materials used for fabricating artificial joints, regardless of whether only one or both articular surfaces of the joint are involved in arthroplasty.

## **3. Simultaneous bilateral joint arthroplasties**

When discussing bilateral joint arthroplasties performed as a single procedure, we are exclusively considering hip and knee arthroplasties. A single-stage bilateral arthroplasties of other joints are not routinely performed, and there are only a few articles dealing with patients when both shoulders were operated in a single procedure. In addition to this, a number of patients mentioned in those articles are quite small [4, 5].

#### **3.1 A single-stage bilateral hip and knee arthroplasty**

Osteoarthrosis of the hip (coxarthrosis) occurs at 4% of the population, and 40–70% percent of patients with coxarthrosis have both hips affected [6, 7] (**Figure 1**). It is considered that 97% of patients with bilateral coxarthrosis will be in need for arthroplasty of the second hip as well [8] (**Figure 2**). With osteoarthrosis

**131**

**Figure 2.**

*Simultaneous bilateral total hip arthroplasty.*

**Figure 1.**

*Bilateral coxarthrosis.*

*Simultaneous Bilateral Joint Arthroplasties in Treatment of Osteoarthritis*

of the knee (gonarthrosis), it is estimated that 10% of patients older than 55 years have clinical symptoms of gonarthrosis [9], with 30–50% of patients having both knees affected and will be in need of bilateral surgery [10, 11] (**Figures 3** and **4**). Patients with bilateral hip or knee osteoarthritis can be surgically treated in a single procedure, by replacing both hip and knee joints under single anaesthesia, or they could be treated in a two-stage procedure with a break between two procedures. Period between two procedures significantly differs among authors. Having in mind differences among authors when it comes to bilateral hip and knee arthroplasties in

a single procedure, we shall analyse them separately.

*DOI: http://dx.doi.org/10.5772/intechopen.93147*

*Simultaneous Bilateral Joint Arthroplasties in Treatment of Osteoarthritis DOI: http://dx.doi.org/10.5772/intechopen.93147*

**Figure 1.** *Bilateral coxarthrosis.*

*Recent Advances in Bone Tumours and Osteoarthritis*

**2. Surgical treatment of osteoarthrosis**

**2.1 Osteotomies of affected joint(s)**

**2.2 Arthrodesis**

**2.3 Joint arthroplasties**

the foot.

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

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.

With the development of new materials and new surgical techniques, arthroplasties of joints have become a primary solution in surgical treatment of osteoarthrosis. However, there are still certain indications for osteotomies, especially for osteoarthrosis of lower leg big joints among young adults, aiming to postpone a total joint arthroplasty. Some studies show that at least 40% of patients with performed osteotomies need a total joint arthroplasty only a few years later [2, 3].

Arthrodesis is a surgical fusion of joints. Nowadays it is rarely performed in big joints, mostly as salvage procedure for treating infection after failed arthroplasty. Arthrodesis is more frequently used in treating osteoarthrosis of small joints in

At this moment, joint arthroplasties are the most preferred solution for degenerative changes in big joints, especially the knees, hips and shoulders. There are numerous reports of arthroplasties of these three joints in last few decades, showing excellent functional results and patient satisfaction. As about elbows, ankles, and small joints of the hands and feet, reported arthroplasty outcomes are still not

There are many different forms of joint arthroplasties regarding types of fixation, articular surfaces and materials used for fabricating artificial joints, regardless of whether only one or both articular surfaces of the joint are involved in arthroplasty.

When discussing bilateral joint arthroplasties performed as a single procedure, we are exclusively considering hip and knee arthroplasties. A single-stage bilateral arthroplasties of other joints are not routinely performed, and there are only a few articles dealing with patients when both shoulders were operated in a single procedure. In addition to this, a number of patients mentioned in those articles are quite small [4, 5].

Osteoarthrosis of the hip (coxarthrosis) occurs at 4% of the population, and 40–70% percent of patients with coxarthrosis have both hips affected [6, 7]

(**Figure 1**). It is considered that 97% of patients with bilateral coxarthrosis will be in need for arthroplasty of the second hip as well [8] (**Figure 2**). With osteoarthrosis

comparable with those in the hips, knees and shoulders.

**3. Simultaneous bilateral joint arthroplasties**

**3.1 A single-stage bilateral hip and knee arthroplasty**

involving application of platelet-rich plasma (PRP) and stem cell therapy.

**130**

**Figure 2.** *Simultaneous bilateral total hip arthroplasty.*

of the knee (gonarthrosis), it is estimated that 10% of patients older than 55 years have clinical symptoms of gonarthrosis [9], with 30–50% of patients having both knees affected and will be in need of bilateral surgery [10, 11] (**Figures 3** and **4**). Patients with bilateral hip or knee osteoarthritis can be surgically treated in a single procedure, by replacing both hip and knee joints under single anaesthesia, or they could be treated in a two-stage procedure with a break between two procedures. Period between two procedures significantly differs among authors. Having in mind differences among authors when it comes to bilateral hip and knee arthroplasties in a single procedure, we shall analyse them separately.

**Figure 3.** *Bilateral gonarthrosis.*

**Figure 4.** *Simultaneous bilateral knee arthroplasty.*
