Quick Answer
There is no single order for hip and knee replacement that suits everyone. Your orthopedic team considers which joint is driving pain and limiting function, examination and imaging findings, overall health, mobility, and rehabilitation needs, then may reassess the other joint after the first surgery.
- The joint that hurts more is important, but it is not the only factor in choosing which operation comes first.
- Hip problems can sometimes cause pain felt in the thigh or around the knee, so pain location alone may not identify its source.
- Examination, imaging, symptom patterns, daily function, medical history, and rehabilitation needs all inform the decision.
- Having substantial problems in both joints does not automatically mean both replacements should happen at the same time.
- After the first operation, the team can review pain, movement, daily function, healing, and readiness for further rehabilitation before planning another procedure.
- There is no single waiting period between operations that applies to everyone.
- Before surgery, ask why a particular joint is recommended first, how the other joint will be reviewed, and how follow-up and rehabilitation will be coordinated.
Both Hip and Knee Need Replacement: How Is the Order of Surgery Decided?
When both your hip and knee may need replacement, there is no single surgical order that suits everyone. Your orthopedic team will weigh which joint is driving your pain and limiting daily activity, confirm the source of symptoms, and consider your health, mobility, and rehabilitation needs. The joint that hurts more is important, but it is not the only factor in deciding which operation comes first.
Hip and knee problems can develop together, sometimes because osteoarthritis affects more than one joint. Even so, needing hip and knee replacement does not automatically mean both procedures should happen at the same time. Your care team may recommend treating one joint first, then reviewing your symptoms and recovery before making a plan for the other. The timing depends on your clinical situation and how you progress, rather than a universal timetable.
If you are considering surgery away from home, sequencing also affects practical planning. Ask how your assessment, rehabilitation, follow-up, and travel arrangements would be coordinated. Make sure the clinicians planning each procedure have access to your imaging, medical history, and medication list. A clear plan can help you understand the reason for the proposed order and what might change it, while leaving room for your care team to adapt the plan as your needs become clearer.
Find Out If Hip Replacement Surgery May Be Right for You
Answer a few short questions and HealthNode will help you connect with the right orthopedic hip specialist.
Pain and Daily Mobility
This helps us understand how much your hip affects walking, sleep, and daily activities.
Previous Diagnosis or Treatment
Tell us what has already been checked or tried before considering surgery.
Surgery Goals and Timing
Tell us what kind of support you are looking for now.
Contact information
Your information is only used to contact you and is never shared with third parties.
Your request has been received!
Thank you. If you have hip X-ray, MRI, CT scan, diagnosis notes, medication history, injection records, physical therapy notes, or previous surgery records, please keep them ready. A HealthNode consultant will guide you through the next step.
Why two damaged joints do not automatically mean two operations together
Osteoarthritis can affect both the hip and knee, causing pain, stiffness, and difficulty with activities such as walking or standing. Other joint damage may also lead to symptoms in more than one area. If an examination and imaging show substantial problems in both joints, your clinician may discuss replacement of each, but that does not by itself determine whether they should be operated on together or in stages.
Staged surgery means one joint is treated first and the other is considered later. This gives the team a chance to see how the first procedure affects your pain, walking, and ability to take part in rehabilitation. It also means the second operation can be planned using information from your recovery rather than relying only on predictions made beforehand.
Whether procedures could be combined or should be separated depends on individual medical and surgical considerations. Your overall health, the demands of recovery, and the support available to you all matter. A plan that is appropriate for one person may not fit someone with different health needs or mobility.
Ask your surgeon to explain why a staged approach, if recommended, fits your situation. The decision is not a judgment about which joint is more important. It is a personalized plan for treating both problems as safely and practically as possible.
What your surgeon weighs before choosing the first joint
Your surgeon will ask where you feel pain, when it occurs, and how it affects daily tasks. Trouble putting on shoes, climbing stairs, standing from a chair, or walking a short distance can help describe the effect on function. Pain severity matters, but so does the pattern of symptoms and whether they match what the examination and imaging show.
Imaging can show changes in the hip and knee, while a physical examination helps assess movement, tenderness, and how you walk. These findings are considered together. A scan or X-ray alone does not capture every part of your experience, so be specific about which activities are difficult and whether symptoms vary over time.
Your medical history also shapes planning. The team may consider health conditions, medicines, previous procedures, and factors that could affect surgical risk or rehabilitation. Be open about your goals, too. For example, you may hope to walk more comfortably, manage stairs, or regain independence with daily routines. These priorities help frame a practical discussion, but they cannot guarantee a particular result.
The plan should reflect both clinical findings and what matters to you. If the proposed first joint is not the one you expected, ask how treating it may affect your walking or rehabilitation. A discussion about joint replacement assessment can clarify what evidence supports the recommendation and what would lead the team to reconsider it.
Why pain around your knee may not start in the knee
Hip problems can sometimes cause pain that is felt in the thigh or around the knee. This is one reason a painful knee should not automatically be assumed to be the main source of symptoms. Your clinician may assess the hip as well as the knee, particularly when the location or pattern of pain does not fit neatly with the knee examination.
The reverse issue can also complicate the picture: when one joint is stiff or painful, you may change how you stand or walk. That altered movement can affect the load on the other joint and make its symptoms more noticeable. It does not prove that one joint caused damage to the other, but it can make it harder to tell which problem is limiting you most.
Describe the location of your pain in your own words. Tell the clinician whether it spreads, whether it changes with hip or knee movement, and which activity brings it on. Mention any numbness, back symptoms, or other concerns, since the source of pain may need careful assessment rather than an assumption based on the area that hurts most.
If you are unsure whether hip or spine problems could contribute to knee symptoms, ask what findings point to each possible source. A careful assessment helps the team decide whether replacement is being considered for the joint responsible for your symptoms and whether another issue needs attention first.
How your first recovery informs the timing of another replacement
After the first operation, the team can review how your pain, movement, and daily function are changing. Your ability to participate in rehabilitation matters because exercises and mobility practice are part of recovery. If the other joint makes walking or exercises difficult, tell your rehabilitation team so they can account for it in your plan.
The timing of a second procedure may also depend on wound healing and your broader medical recovery. The treating team will consider whether you are ready for another operation and whether your health and support arrangements allow for a further period of rehabilitation. There is no single interval that applies to everyone, so avoid treating another person’s timeline as a rule for your own care.
For some people, the first operation changes how the other joint feels. Reduced pain or a different walking pattern may make symptoms elsewhere more noticeable, less limiting, or simply easier to assess. Your care team may reassess the second joint rather than assuming the original plan must stay unchanged.
If you are arranging treatment across countries, ask how follow-up will work after you leave the surgical location. Confirm which team will review healing and rehabilitation progress, how records will be shared, and who to contact if a concern arises. These details help connect the first recovery with a sound decision about what comes next.
What to settle before the first operation is scheduled
Before surgery, ask which joint the team recommends treating first and what examination or imaging findings support that choice. Discuss what the first procedure is expected to address, how the other joint may affect your mobility, and when its symptoms will be reviewed. It is reasonable to ask what could change the plan after surgery.
Talk through rehabilitation and home support before setting a date. You may need help with daily activities while your mobility is limited, and your home setup may affect how manageable recovery feels. Ask what equipment or assistance might be appropriate for you, and how your rehabilitation plan will account for discomfort in the untreated joint.
Give the care team a complete list of your medicines, supplements, allergies, and health conditions. Ask which medicines, if any, need adjustment and who is responsible for those instructions. Do not stop or change a prescribed medicine on your own. If you are travelling for care, agree on how you will receive written instructions and communicate with the team after returning home.
Before leaving the pre-surgery discussion, make sure you know whom to contact about new or worsening symptoms and what follow-up is planned. If the first operation changes your pain or function in an unexpected way, report that before proceeding with another procedure. The next decision should be made with an updated view of your health and recovery.
Find Out If Hip Replacement Surgery May Be Right for You
Answer a few short questions and HealthNode will help you connect with the right orthopedic hip specialist.
Pain and Daily Mobility
This helps us understand how much your hip affects walking, sleep, and daily activities.
Previous Diagnosis or Treatment
Tell us what has already been checked or tried before considering surgery.
Surgery Goals and Timing
Tell us what kind of support you are looking for now.
Contact information
Your information is only used to contact you and is never shared with third parties.
Your request has been received!
Thank you. If you have hip X-ray, MRI, CT scan, diagnosis notes, medication history, injection records, physical therapy notes, or previous surgery records, please keep them ready. A HealthNode consultant will guide you through the next step.
Frequently Asked Questions
Q: Is the more painful joint always replaced first?
A: Not always. Pain matters, but your surgeon also considers function, examination and imaging findings, overall health, and rehabilitation needs. Explain which activities are hardest for you and ask why the recommended joint should be treated first.
Q: Can a hip problem cause pain around my knee?
A: Yes, hip problems can sometimes cause pain felt in the thigh or around the knee. The location of pain alone may not identify its source. Ask your clinician how the hip and knee examination findings help distinguish them.
Q: Can hip and knee replacements happen at the same time?
A: Whether combined surgery is appropriate depends on your health, surgical considerations, and recovery needs. Many plans treat one joint first and reassess later, but your care team can explain what options fit your circumstances. Do not assume that another patient’s plan applies to you.
Q: How long should I wait between hip and knee replacements?
A: There is no universal waiting period for everyone. The interval can depend on healing, medical recovery, mobility, and readiness to take part in another rehabilitation period. Ask your treating team what milestones they will review before discussing another operation.
Q: What if my other joint feels different after surgery?
A: Tell your care team if symptoms in the untreated hip or knee change after the first procedure. Changes in pain or walking may affect how the second joint is assessed. The plan can be reviewed using your recovery and current symptoms.
The information provided is for educational purposes only and does not constitute medical advice. Always consult with a healthcare professional for medical guidance specific to your situation.
