Unilateral versus simultaneous bilateral total hip arthroplasty. The Belgian experience
Acta Orthopaedica Belgica
|January 11, 2024
Summary
Simultaneous bilateral total hip arthroplasty (SBTHA) is as safe as unilateral total hip arthroplasty (UTHA) for treating hip osteoarthritis. SBTHA does not increase complication rates, readmissions, or ER visits, making it a viable option.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Osteoarthritis Research
Background:
- Bilateral hip osteoarthritis is common, yet the safety of simultaneous bilateral total hip arthroplasty (SBTHA) compared to unilateral total hip arthroplasty (UTHA) remains debated.
- Patient selection criteria for SBTHA require further clarification to optimize outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of SBTHA by comparing complication rates and patient outcomes against UTHA.
- To share clinical experience regarding the direct anterior approach for both UTHA and SBTHA.
Main Methods:
- A retrospective analysis of 468 patients (418 UTHA, 50 SBTHA) who underwent hip arthroplasty via a direct anterior approach between June 2016 and December 2020.
- Primary outcomes included 90-day emergency room visits, readmissions, and minor/major complications. Secondary outcomes were length of stay, operative time, and blood loss.
Main Results:
- No statistically significant differences were observed in 90-day ER visits, readmissions, or overall complication rates between SBTHA and UTHA groups.
- While SBTHA involved longer operative times and length of stay, with increased blood loss, transfusion rates remained similar.
- SBTHA patients were significantly younger, but preoperative demographics and comorbidities were comparable.
Conclusions:
- SBTHA demonstrates similar complication rates, 90-day readmission, and 90-day ER visit rates compared to UTHA.
- Performing SBTHA is a safe and effective procedure for patients with bilateral symptomatic hip osteoarthritis, without introducing additional risks.
