Are There Benefits to One- versus Two-stage Procedures in Bilateral Hip Resurfacing?

Abstract

Background Short-term studies report comparable complication rates of one-stage bilateral versus two-stage procedures in hip resurfacing, although the long-term effects of such procedures on survivorship, quality of life, and disease-specific scores are currently unknown. Questions/purposes We compared clinical scores, length of stay, complication rates, and survivorship in patients who underwent bilateral hip resurfacing grouped on the basis of one-stage versus two-stage operation. Patients and Methods We retrospectively reviewed 75 patients who underwent a one-stage procedure and 87 patients who had both hips resurfaced in separate procedures. The demographics and etiologies were similar for the two groups. The mean followup time was longer in the two-stage group (7.3 years; range, 2.6-12.3 years) than in the one-stage group (6.6 years; range, 2.6-10.9 years). Results We found no differences in the latest postoperative UCLA pain, walking function, and activity scores; Harris hip scores; or SF-12 scores between the two groups. The average length of stay was shorter for the one-stage group. The early complication rates were similar between the two groups. One-stage patients had a higher revision rate than the patients in the two-stage group (14 versus four hips, respectively), but this was not true for patients with femoral components 48 mm or greater in size. Conclusions We found a greater rate of revisions in the one-stage group, suggesting possible long-term detrimental effects of the one-stage procedure. Our data suggest selecting patients with large component sizes if the surgeries are to be performed under one anesthesia.

One‐Stage Arthroplasty or Revision for Seronegative Infections in Hip and Knee

“…In addition, this method can reduce the number of surgeries required. To our knowledge, most of the previous findings suggest that single‐stage and two‐stage revision can both achieve satisfactory clinical outcomes after prosthesis infection (Table ). In our study, these 24 patients also had good outcomes in terms of their joint function and daily life; the one‐stage TJA or revision surgery for patients who had seronegative infections can give them a better life and did not increase the rate of infection.…”

Socket Position Determines Hip Resurfacing 10-Year Survivorship

“…Twelve hips underwent revision surgery in this series. In one hip the acetabular component migrated through the acetabular wall and was reconstructed with a cemented crosslinked polyethylene acetabular component articulating with the original resurfacing femoral head [7]. Two hips sustained a femoral neck fracture 5 months after resurfacing and were converted to a conventional THA.…”

“…The patients were followed 4 months after surgery and then annually. We used the UCLA hip scoring system [7] to assess pain, walking ability, function, and activity and the SF-12 [28] to evaluate the patient's quality of life. In case a patient could not be followed in our clinic, a telephone consultation was arranged after the patient had forwarded to our office a set of recent radiographs performed at a local orthopaedist facility and following our protocol.…”

Tips and tricks for successful hip resurfacing

“…Dr Amstutz has reported from a study of 75 one-stage (simultaneous) resurfacing cases and 87 two-stage operations that a simultaneous bilateral surgery has no greater risk of early complications and less risk of longterm complications than two separate procedures (Amstutz et al, 2010). When McBryde et al (2007) compared the outcome of 37 simultaneous and 55 two-stage bilateral resurfacing operations, they found no significant difference in complication rates or transfusion requirements between the two groups, but a notable cost saving with the one-stage procedure.…”