Perioperative morbidity after single-stage bilateral total hip arthroplasty: a matched control study

Area of Science:

• Orthopedic Surgery
• Surgical Outcomes
• Patient Safety

Background:

• Bilateral total hip arthroplasty offers potential benefits but raises concerns about increased perioperative risks.
• Understanding the comparative morbidity and mortality is crucial for surgical decision-making.

Purpose of the Study:

• To evaluate whether perioperative morbidity and mortality increase in patients undergoing bilateral single-stage total hip arthroplasties compared to unilateral procedures.

Main Methods:

• Retrospective comparison of 400 patients with bilateral total hip replacements versus 400 matched patients with unilateral replacements.
• Matching criteria included age, gender, American Society of Anesthesiologists (ASA) classification, body mass index, and diagnosis.
• Outcomes assessed included mortality, minor and major complications, dislocation, fat emboli syndrome, and blood transfusions.

Main Results:

• No deaths occurred in either group.
• Bilateral procedures showed more minor complications per hip and a trend towards more major complications.
• Increased trends in dislocation and fat emboli syndrome were observed in the bilateral group.
• Similar blood transfusion rates but higher allogeneic blood use in the bilateral group.
• ASA classification was the sole independent predictor for complications.

Conclusions:

• Bilateral single-stage total hip arthroplasty presents an acceptable perioperative risk profile for patients with ASA Class 1 or 2.
• Further investigation may be warranted for higher-risk patient groups.