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Perioperative morbidity and mortality following bilateral total hip arthroplasty

Mohammad R Rasouli1, Mitchell G Maltenfort, David Ross

  • 1Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, Pennsylvania.

The Journal of Arthroplasty
|May 14, 2013
PubMed

Insights

Bilateral total hip arthroplasty (THA) increases systemic complication risks compared to unilateral surgery. Simultaneous bilateral THA is safer than staged bilateral THA within one hospitalization.

Area of Science:

  • Orthopedic Surgery
  • Patient Safety
  • Health Outcomes Research

Background:

  • Concerns exist regarding the safety of performing bilateral total hip arthroplasty (THA).
  • Understanding complication rates is crucial for surgical decision-making in THA procedures.

Purpose of the Study:

  • To compare in-hospital complication rates between unilateral, simultaneous bilateral, and staged bilateral THAs.
  • To identify differences in systemic and local complication risks associated with different bilateral THA approaches.

Main Methods:

  • Utilized data from the Nationwide Inpatient Sample (2002-2010).
  • Identified patients and complications using ICD-9-CM codes.
  • Performed multivariate analysis to assess complication risks.

Main Results:

  • Bilateral THA demonstrated a higher risk of systemic complications compared to unilateral THA (OR: 2.1, P<0.001).
  • Local complication rates were higher in bilateral versus unilateral THA (4.96% vs. 4.54%, P=0.009).
  • Staged bilateral THA showed a higher risk of local complications than simultaneous bilateral THA (OR: 1.75, P=0.05).

Conclusions:

  • Bilateral THA is associated with an increased risk of systemic complications compared to unilateral surgery.
  • Simultaneous bilateral THA appears safer than staged bilateral THA within a single hospitalization.
  • These findings inform surgical strategies to minimize complications in patients undergoing bilateral hip replacement.

Keywords:
bilateral total hip arthroplastymorbiditymortalitynationwide inpatient sample

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