We treated eighteen non-ambulatory patients by multiple operations
consisting of total replacement of the hip or the knee, or both. Thirteen
patients had rheumatoid arthritis, four had degenerative arthritis, and one
had had bilateral resection of the femoral head and neck. The patients were
followed for an average of forty months. We devised a classification based
on the number of joints involved and a rating scale for function. Good to
excellent results were achieved in the patients who had two or three joints
operated on (with one exception). Fifteen patients became ambulatory and
seven could climb stairs. Seven patients were pain-free. The factors
responsible for poor results were significant neural problems and loss of
motivation. The presence of severe upper-extremity involvement was not an
obstacle preventing walking.