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Is one-stage bilateral sequential total hip replacement as safe as unilateral total hip replacement?
1The Joint Replacement Center of Korea, Ewha Womans University School of Medicine Mok Dong Hospital, 911-1, MokDong, YangChun-Gu, Seoul 158-70, Korea. younghookim@ewha.ac.kr
The Journal of Bone and Joint Surgery. British Volume
|March 5, 2009
Summary
Simultaneous bilateral total hip replacement (THR) shows similar mortality rates to unilateral THR in both low- and high-risk patients. While bilateral THR requires more transfusions and longer hospital stays, overall complication rates remain comparable, confirming its safety.
Area of Science:
- Orthopedic Surgery
- Anesthesiology
- Patient Risk Stratification
Background:
- Total hip replacement (THR) is a common procedure for hip joint issues.
- Simultaneous bilateral THR offers potential benefits but requires safety evaluation.
- Patient risk stratification, using American Society of Anesthesiologists (ASA) grading, is crucial for surgical outcomes.
Purpose of the Study:
- To compare the mortality and complication rates of simultaneous bilateral THR versus unilateral THR.
- To assess outcomes in both low-risk and high-risk patient groups based on ASA classification.
- To determine the safety and efficacy of bilateral THR in diverse patient populations.
Main Methods:
- Retrospective study comparing 978 patients undergoing simultaneous bilateral THR with 1666 patients undergoing unilateral THR.
- Analysis of pre-operative data including age, BMI, diagnosis, and ASA risk grading.
- Follow-up duration averaged 10.5 years for bilateral THR and 9.8 years for unilateral THR.
Main Results:
- Peri-operative mortality rates were similar: 0.31% for bilateral THR vs. 0.18% for unilateral THR.
- Mortality rates were comparable between high- and low-risk patients in both bilateral and unilateral THR groups.
- Bilateral THR patients experienced more blood transfusions and longer hospital stays, but overall complication rates were not significantly different (p=0.32).
Conclusions:
- Simultaneous sequential bilateral THR is a safe surgical option for both low- and high-risk patients.
- The procedure demonstrates comparable peri-operative mortality and overall complication rates to unilateral THR.
- While resource utilization is higher for bilateral THR, it does not compromise patient safety.
