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One-stage bilateral total hip arthroplasty: functional outcomes and complications in 112 patients
C Trojani1, T d'Ollonne, D Saragaglia
1Department of Orthopaedics and Sports Trauma, De l'Archet Hospital, Nice Teaching Medical Center, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France. trojani.c@chu-nice.fr
Background:
Advantages of one-stage bilateral total hip arthroplasty (THA) include a single hospital stay, a shorter rehabilitation time, and decreased management costs per patient. However, concern about a possible increase in the perioperative complication rate has limited the use of this strategy. Here, our objectives were to evaluate morbidity and mortality, as well as functional outcomes, in patients managed with one-stage bilateral THA.
Hypothesis:
The complication rate after one-stage bilateral THA is not significantly different from that after unilateral THA.
Materials And Methods:
Four French surgical centres participated in a retrospective observational study of patients managed with one-stage bilateral THA. The 112 included patients (55 women) had a mean age of 59 years (range, 22-84) and a mean follow-up of 30 months (6-103).
Results:
Mean hospital stay length was 10.8 days (6-27), mean operative time was 162 minutes (95-270), and mean haemoglobin levels were 14.3g/dL preoperatively and 10.1g/dL postoperatively. No perioperative deaths were recorded. Deep vein thrombosis occurred in eight (7.1%) patients and pulmonary embolism in six (5.4%). The Merle d'Aubigné score improved from 9.25 ± 2.9 (3-16) preoperatively to 17.5 ± 1 (14-18) at last follow-up. All but three patients (109/112, 97%) said they would choose the same operation again and 102/112 (91%) said they would recommend it to a family member.
Discussion:
The results of this multicentre retrospective study indicate that one-stage bilateral THA is a valid alternative to two-stage bilateral THA in ASA 1 and 2 patients with a preoperative haemoglobin level of about 14 g/L. The major complication rate was 7.1%, which was slightly higher than after unilateral THA, and the main complications were deep vein thrombosis and pulmonary embolism.