simultaneous quadruple total hip and knee joint replacements Wang Jincheng Yu Tao Gao Zhongli Chen Wei Wu Dankai Wang Jincheng, Department of Bone and Joint, The Second Hospital of Jilin University Ankylosing spondylitis, rheumatoid arthritis, and other diseases can cause hip and knee quadruple joint disorders, severe pain in the hip and knee joints, and functional limitations. Life can not take care of themselves, long-term bedridden, commonly known as “wooden man”. Folk call this kind of disease as “immortal cancer”. Artificial joint replacement can make the “wooden man” become a “puppet man”, and eventually become a “normal person” through rehabilitation. Four joints replacement or ipsilateral joints replacement has the following disadvantages: 1, need 2-4 times of surgery; 2, long treatment cycle; 3, patients suffer a lot of pain, easy to lose confidence in the recovery; 4, high cost; 5, not easy to postoperative rehabilitation; 6, the risk of multiple anesthesia; 7, increase the time of bed rest and the occurrence of related complications. Simultaneous replacement of the four joints can be avoided, but the risk is high, the operation is difficult and the time is long. Requirements for simultaneous replacement: comprehensive strength of the hospital: anesthesia, monitoring, nursing care, rehabilitation, etc., rich experience in difficult joint replacement, excellent surgical skills, detailed treatment plan, prevention of complications and countermeasures. The significance of simultaneous replacement: shortening the operation time, avoiding the operation risk, and successfully completing the simultaneous hip and knee quadruple joint replacement surgery is of course the strength of orthopaedic department of a hospital or a school! 2009.2~2009.10, Department of Orthopaedics, Baiqiu’en Third Hospital of Jilin University, Joint Surgery Group successfully accomplished 4 cases of hip and knee quadruple joint replacement, with the largest number of cases, the shortest operation time, and satisfactory operation effect! So far, there are 13 cases of hip and knee quadruple joint replacement all over the world! Treatment: Bilateral total hip replacement, bilateral total knee surface replacement, biological prosthesis. The order of surgery was right hip, left hip, right knee, left knee. Surgical time averaged 3.5 hours. Overall blood transfusion averaged 1500 ml. postoperative joint pain disappeared. An autologous blood transfusion device was used intraoperatively and postoperatively. Knee replacement utilizing blood repellent tape and postoperative elastic bandage. Low molecular heparin anticoagulation was performed on the first postoperative day. Muscle contraction exercises were performed on the first postoperative day. On the third postoperative day, passive hip and knee exercises were started. 2 weeks later, the patient was encouraged to perform bedside exercises with the aid of assistive devices and learn to walk. Typical case: Female, 29 years old, with ankylosing spondylitis. The right hip was flexion-adduction ankylosis. The left hip was in flexion and ankylosis. Right knee flexion and valgus, left knee flexion deformity. Medical history 7 years, bedridden for 3 years. Preoperative intraoperative Postoperative