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

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Reconstructive Surgery

Background:

• Controversy exists regarding complication rates for 1-stage vs. 2-stage bilateral total hip arthroplasty (THA).
• Previous studies have not definitively established the comparative safety and efficacy of these procedures.

Purpose of the Study:

• To compare the complication rates and functional outcomes of 1-stage and 2-stage bilateral THA.
• To evaluate the safety and effectiveness of same-day bilateral hip replacement.

Main Methods:

• Randomized controlled trial involving 180 patients with bilateral hip osteoarthritis.
• Comparison of 1-stage bilateral THA versus 2-stage bilateral THA using the Hardinge approach with uncemented implants.
• Postoperative evaluation at 1 year, assessing functional outcomes (Harris Hip Score) and complications.

Main Results:

• No significant difference in Harris Hip Score between 1-stage (84.1) and 2-stage (82.6) groups (p=0.528).
• Significantly shorter hospital stay in the 1-stage group (4.9 days) compared to the 2-stage group (9.8 days).
• Similar rates of hemoglobin drop, blood transfusion, deep venous thrombosis, and no occurrences of perioperative death, pulmonary embolism, infection, dislocation, fracture, or heterotopic ossification.

Conclusions:

• 1-stage bilateral THA is a successful procedure for bilateral hip disease, not associated with increased complications.
• Functional and clinical outcomes are comparable between 1-stage and 2-stage bilateral THA.
• 1-stage bilateral THA offers a significantly shorter hospital stay, improving patient recovery and resource utilization.