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Sequential bilateral total hip replacement during the same hospitalization.
Brian A Jewett1, Dennis K Collis
1Orthopedic Healthcare Northwest, Eugene, OR 97405, USA. Brian.Jewett@OHN.com
Clinical Orthopaedics and Related Research
|December 7, 2005
Summary
Sequential bilateral total hip replacement within the same hospitalization offers a safe and effective alternative to simultaneous or staged procedures. This approach demonstrated significant improvements in patient hip function and favorable implant survivorship over 32 years.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
Background:
- Simultaneous bilateral total hip replacement and staged procedures (separated by >6 weeks) are established protocols.
- A unique protocol of sequential bilateral total hip replacement within the same hospitalization, separated by 5–7 days, was evaluated.
Purpose of the Study:
- To compare the outcomes of sequential bilateral total hip replacement performed during the same hospitalization with existing literature on simultaneous or staged bilateral hip replacement.
Main Methods:
- A 32-year retrospective review (1972–2004) of 112 patients undergoing sequential bilateral total hip replacement.
- All surgeries utilized a direct lateral approach with various cemented and cementless implants.
- Data analysis included length of stay, functional outcomes (Iowa hip scores), implant survivorship, and complication rates.
Main Results:
- Average length of stay was 13.8 days.
- Iowa hip scores improved significantly from 42 to 94 points at an average follow-up of 6.3 years.
- Implant survivorship was comparable to other reports; two delayed infections occurred, and 16 patients had medical complications, including one fatal pulmonary embolism.
Conclusions:
- Sequential bilateral total hip arthroplasty within the same hospitalization is a viable alternative for carefully selected patients.
- This approach provides comparable efficacy and safety to other bilateral hip replacement timing protocols.