Can two hips with the same condition be treated in different ways?
Dr. Mahajan is Chairman Orthopaedics, Joint Replacement & Chief Robotic Joint Replacement at Max Smart Super Speciality Hospital, Saket.
A man who had had pain in his hips for more than three years, and had been advised a hip replacement where he lived, came to Dr Ramneek Mahajan.
How long had the patient's hips hurt?
The patient says that more than three years earlier he began to have pain in his legs, mostly in his hips. Tests at a hospital where he lived found a problem in his hips, and he was advised to have a hip replacement.
What did the doctor find?
Dr Mahajan says the patient had avascular necrosis, the death of bone tissue because its blood supply is lost, in both hips.
Why this operation, and what was done?
Dr Mahajan describes the two operations. The plan was to operate on the more advanced side first, with a hip replacement. That hip was replaced from the front of the hip with a robot's help. The other hip had a core decompression, and bone marrow and a graft of the patient's own bone were put in.
A core decompression drills small channels into damaged bone to relieve the pressure inside it. A bone graft is bone placed where bone is damaged, to help it heal. In a robot-assisted hip replacement, the surgeon uses a robotic arm to guide the cuts.
How is the patient now?
The patient says he can now walk without any support or walker.
What should a patient with avascular necrosis in both hips ask?
This is one man's story, not a promise: what an operation can do for you depends on your own case.
Ask whether both hips are damaged to the same degree, and whether each needs the same operation.
Ask what can be done for a hip that is not yet ready for a replacement.
What this case teaches
Without its blood supply, the bone in the ball of the hip dies and gradually collapses, the American Academy of Orthopaedic Surgeons explains.
Robotic help restored the hip's natural shape more closely, though operations took longer, a 2025 review of 38 studies found.
Hip replacement relieves pain and restores function in most people with osteonecrosis, the American Academy of Orthopaedic Surgeons says.
