Simultaneous bilateral hip replacement reveals superior outcome and fewer complications than two-stage procedures: a prospective study including 1819 patients and 5801 follow-ups from a total joint replacement registry

Aghayev, Emin; Beck, Andreas; Staub, Lukas; Dietrich, Daniel; Melloh, Markus; Orljanski, Weniamin; Röder, Christoph

doi:10.1186/1471-2474-11-245

Cited by 77 publications

(78 citation statements)

References 24 publications

(34 reference statements)

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“…The likelihood that high-risk patients would undergo contralateral THA was 97%. For these patients, simultaneous bilateral THAs may offer decreased complication rates [1,3,18] and be more costeffective [18]. Parvizi et al [18] reported on 98 patients who received simultaneous bilateral THAs versus 98 patients who received staged bilateral THAs, with a minimum 6-month followup of perioperative complications.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Contralateral THA After Index THA for Osteoarthritis

Sayeed

Johnson

Mont

2012

Clinical Orthopaedics &Amp; Related Research

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Background Currently more than 200,000 THAs are performed annually in the United States. In patients with bilateral disease, the chance of subsequent contralateral THA reportedly ranges from 16% to 85%. Factors influencing contralateral THA are not completely understood. Questions/Purposes We therefore determined (1) the 10-year probability free of progression to contralateral THA after index THA, (2) whether demographics differed between those who did and did not ultimately undergo contralateral THA, and (3) whether initial clinical symptoms and/or degree of radiographic osteoarthritis affects progression. Patients and Methods We retrospectively identified 332 patients with minimum 24-month followup and primary osteoarthritis who underwent unilateral THA between 2001 and 2008. There were 150 men and 182 women with a mean age of 61 years (range, 27-93 years) and a mean BMI of 29.6 kg/m 2 (range, 17.6-49.2 kg/m 2 ). We reviewed clinical, radiographic, and demographic data at index THA and last followup and classified patients as low, indeterminate, or high risk of undergoing contralateral THA.Results Seventy-four of the 332 patients (22%) underwent contralateral THA, resulting in an 83% 10-year probability free of progression to the contralateral hip. Low-risk patients had a less than 1% chance of progression, indeterminate-risk patients had a 16% to 24% chance of progression, and high-risk patients had a 97% chance of progression.

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Section: Discussionmentioning

confidence: 99%

Incidence of Contralateral THA After Index THA for Osteoarthritis

Sayeed

Johnson

Mont

2012

Clinical Orthopaedics &Amp; Related Research

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“…Other researchers 9 have shown simultaneous bilateral THA to be more effective than staged THA because it allows for substantial improvement in hip motion and better functional recovery. Aghayev et al 10 demonstrated that patients who underwent simultaneous bilateral THA have a lower rate of major systemic complications when compared with two-staged bilateral THA in a study enrolling 1819 patients. Parviziet al 11 demonstrated that there is no difference in systemic complications between unilateral THA and simultaneous bilateral THA.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Cohort Study Comparing Complications, Readmission, Transfusion, and Length of Stay of Patients Undergoing Simultaneous and Staged Bilateral Total Hip Arthroplasty

Guo

Shao

Huang

et al. 2020

Orthopaedic Surgery

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Objectives To determine whether the rates of postoperative complications, rate of readmission, cumulative transfusion volume, and length of stay (LOS) differ between simultaneous total hip arthroplasty (THA) and staged bilateral THA and to assess whether the length of the interval between staged procedures influences surgery outcome. Methods This was a retrospective cohort study comparing the rate of postoperative complications, readmission, cumulative transfusion volume, and LOS between simultaneous THA and staged bilateral THA in our hospital's registration database. The inclusion criteria is listed as follows: patients who underwent bilateral primary THA between January 2011 and January 2015 with minimum 3‐month follow‐up; simultaneous bilateral THA; staged bilateral THA; postoperative complications, readmission, cumulative transfusion volume, length of stay of the patients and the influence of the interval between stages of bilateral THA on the outcome above; and retrospective cohort study. Finally, a total of 1145 patients, including simultaneous bilateral THA in 863 patients (1726 hips) and staged bilateral THA in 282 patients (564 hips), were eligible for the present study. The patients were divided into three groups according to the interval time (≤30 days, 30–90 days, >90 days) between the two stages of bilateral THA and we compared postoperative complications, readmission rates, cumulative transfusion volume, and LOS for the three groups. All patients’ medical records and outpatient notes were reviewed to extract preoperative data, perioperative complications, readmission, cumulative transfusion, and LOS. Preoperative information included patients’ age, sex, diagnosis, body mass index, and American Society of Anesthesiologists (ASA) classification. Perioperative complications were sorted into two groups: (i) medical complications included cardiovascular, pulmonary, neurological, digestive, and urologic system complications, along with other miscellaneous issues; and (ii) surgical complications included dislocation, superficial wound infection, hematoma, deep periprosthetic joint infection, and nerve palsy. Patients who failed to come back to visit our hospital in the postoperative 3 months were followed up by telephone, at which point we inquired about any postoperative complications and readmission. Results Simultaneous THA was performed more often in younger men, and patients in the simultaneous group had fewer major medical complications (excluding venous thromboembolism), fewer surgical complications, and shorter hospital stays; however, patients in the simultaneous group were likelier to have a higher transfusion rate than patients in the staged group. Among patients in the staged group, there were no differences for differing time intervals, except that patients with a between‐stage interval of ≤30 days required more blood transfusions. Conclusion With careful patient assessment and selection, simultaneous bilateral THA is a safe procedure, and has lower rates of surgical and major medical complic...

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“…As has been shown in previous studies, sequential bilateral THA decreases costs [1] and shortens rehabilitation time [11]. Better postoperative outcomes after sequential bilateral THA than after two-stage bilateral THA have been reported in several patient series [22, 23], and have been confirmed in a meta-analysis [12]. With regard to safety, the study findings are in concordance with a recent meta-analysis that concluded that simultaneous bilateral THA does not lead to an unacceptably high rate of complications or rate of death, compared with a staged bilateral approach [12].…”

Section: Discussionmentioning

confidence: 82%

Sequential Bilateral Total Hip Arthroplasty Through a Minimally Invasive Anterior Approach is Safe to Perform

Petridis¹,

Nolde²

2017

TOORTHJ

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Background:Sequential bilateral total hip arthroplasty (THA) has the potential advantages of a single operative intervention with a single hospital stay, alongside reduced costs and total rehabilitation times. Its use has been limited, however, by a theoretical increase in perioperative complications.Objective:The purpose of this study was to assess functional outcomes and complications in patients undergoing sequential bilateral THA performed using anterior minimally invasive surgery (AMIS). We hypothesized that sequential bilateral THA yields favorable clinical outcome and is safe to perform.Methods:Two surgical centres conducted a retrospective observational analysis of 130 patients (77 females) with a mean age of 57 (range, 35-77) years, all of whom were treated by one surgeon and followed up for 24 months.Results:The mean length of hospital stay length was 8.4 (range, 6–18) days. The mean operative time was 162 (range, 92–185) minutes, the mean intraoperative blood loss was 499.1ml, and the mean preoperative and postoperative hemoglobin levels were 14.3 g/dl and 11.3 g/dl, respectively. No perioperative complications or deaths were recorded. The Harris Hip Score (HHS) improved from 44.5 ±13.7 preoperatively to 98.9 ± 1.0 at final follow-up. Also the High Activity Arthroplasty Score (HAAS) and the Questions on Life Satisfaction (FLZ) score improved significantly.Conclusion:This retrospective analysis suggests that, in selected patients, sequential bilateral THA via an anterior minimally invasive approach appears to be a valid alternative to two-stage bilateral THA. Further studies are warranted.

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Simultaneous bilateral hip replacement reveals superior outcome and fewer complications than two-stage procedures: a prospective study including 1819 patients and 5801 follow-ups from a total joint replacement registry

Cited by 77 publications

References 24 publications

Incidence of Contralateral THA After Index THA for Osteoarthritis

Incidence of Contralateral THA After Index THA for Osteoarthritis

Retrospective Cohort Study Comparing Complications, Readmission, Transfusion, and Length of Stay of Patients Undergoing Simultaneous and Staged Bilateral Total Hip Arthroplasty

Sequential Bilateral Total Hip Arthroplasty Through a Minimally Invasive Anterior Approach is Safe to Perform

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