To make the high school cheerleading team 40 years ago, twins Deborah and Sandra Fanelli performed an acrobatic move called "the flying splits."
The memory recently drew a rueful laugh from the once-active sisters, who in recent years have had trouble simply walking.
Severe arthritis has nearly crippled Sandra, known as Sam, who uses a walker. Deb has relied on a cane.
But on Friday, the 56-year-old twins, who have lived their entire lives together, were wheeled into side-by-side operating rooms at Rothman Orthopaedic Specialty Hospital in the Philadelphia suburb of Bensalem.
Deb received a right hip replacement and Sam had surgery on both hips as part of Operation Walk USA, a program that offers free knee and hip replacements to uninsured patients like the Fanellis.
"I'm just incredibly grateful and in awe of this procedure," Sam said, just hours after surgery as she took her first steps down a hospital corridor to visit her sister.
Doctors, hospitals and implant manufacturers donate time and equipment for the procedures. A hip replacement would normally cost about $16,000, plus hospitalization, according to Rothman officials.
The program started in the mid-1990s to serve patients in developing countries but has been offered in the U.S. for only the past two years. The Fanelli twins were among five patients at Rothman, and among 200 people nationwide, receiving free new joints on Friday.
The sisters had become increasingly debilitated with arthritis after dancing and singing professionally for 20 years, including eight years at a casino in Atlantic City, N.J.
They have been living in their childhood home in Clementon, N.J., with their spry and doting 81-year-old mother, Blanche, who has watched with alarm as her daughters' conditions have deteriorated.
"Because I'm not a young person," Blanche said in an interview Thursday. "And I thought, 'Oh, my gosh, who's going to take care of them?'"
Over the past few years, Sam has run a small gourmet cookie business out of the house and Deb has sold cosmetics. But their outings have been minimal, limited mainly to the grocery store and their parish church.
"It's hard to even get up some days," Deb said. "The hip pain and the limitations have robbed us of our freedom and robbed us of our, just, mental joy, to get up and live."
Sam's problems started about 10 years ago. One hip became so painful that their father paid for an experimental replacement procedure in 2003, but Sam saw little improvement. Deb's leg gave out a couple of years later and has gotten progressively worse. The twins have never had health insurance.
Then earlier this year, a friend told them about Operation Walk USA. The family was overcome with joy when they found out both sisters qualified for free surgery.
Dr. Bill Hozack, who gave Sam a new left hip and fixed the old replacement on her right hip, said the operations went well.
"Assuming everything heals properly, no complications — which is usually the case — they should be able to go out and do everything they want to do and not have any problems with the hips," Hozack said.
For now, the sisters must recover and begin re-learning to walk on their new joints. After a tearful reunion in Deb's hospital room Friday afternoon, they said they looked forward to this new phase in their lives.
"I'm flabbergasted. I'm overwhelmed," Deb said. "The worst is behind us. We're going to be great."
A day earlier, the twins had said one of their first goals is to participate this spring in a fundraising walk for ovarian cancer, in memory of a dear friend.
"The first year we went to participate, we had to sit on the sidelines and just kind of watch everybody," Deb said. "So this year, we want to get out there and walk."
"Definitely," added Sam. "I can't wait."
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