Bilateral total hip arthroplasty: one-stage versus two-stage procedures

Area of Science:

• Orthopedic Surgery
• Arthroplasty Procedures

Background:

• Bilateral hip arthritis necessitates surgical intervention, with total hip arthroplasty (THA) being a common treatment.
• Surgical approaches include one-stage (simultaneous bilateral) and two-stage (staged bilateral) procedures, each with potential benefits and drawbacks.

Purpose of the Study:

• To compare the clinical outcomes, complications, and costs of one-stage versus two-stage bilateral total hip arthroplasty.
• To evaluate the safety and efficacy of performing bilateral THA in a single operative session.

Main Methods:

• Retrospective review of 196 patients (392 hips) undergoing bilateral THA.
• Patients were divided into a one-stage group (98 patients) and a two-stage group (98 patients).
• All patients received uncemented components under spinal anesthesia with identical rehabilitation protocols.

Main Results:

• Functional outcomes were comparable between the one-stage and two-stage groups.
• The two-stage group experienced higher rates of complications, primarily anemia and wound drainage.
• The one-stage group demonstrated significantly shorter hospital stays (4.3 days vs. 8.1 days) and lower total expenses ($45,900 vs. $64,600).

Conclusions:

• One-stage bilateral total hip arthroplasty is a safe and cost-effective option for young, healthy patients.
• This approach can lead to reduced resource utilization without compromising patient outcomes.
• Careful patient selection is crucial for optimizing the benefits of one-stage bilateral THA.