Perioperative morbidity after single-stage bilateral total hip arthroplasty: a matched control study.
We asked whether the perioperative morbidity and mortality of patients having bilateral single-stage total hip arthroplasties would be increased. We retrospectively compared 400 patients who had bilateral total hip replacements with a matched group of 400 patients who had unilateral total hip replacements. Patients were matched according to age (+/- 1 year), gender, American Society of Anesthesiologists (ASA) classification, body mass index (+/- 4 kg/m), and diagnosis (osteoarthritis, 81.2%). There were no deaths in either group. The group of patients who had bilateral total hip arthroplasties had a greater number of minor complications per hip (0.34 +/- 0.6 versus 0.25 +/- 0.6) but only a trend toward an increased number of major complications per hip (0.037 +/- 0.2 versus 0.015 +/- 0.1). Patients who had bilateral total hip arthroplasties had a trend toward increased risk of dislocation (1.6%/hip versus 0.5%/hip). The patients in this group also had increased number of fat emboli syndrome per surgically treated hip (0.015 versus 0.0025). Based on a calculation per surgically treated hip, patients who had bilateral total hip arthroplasties had a similar percentage of blood transfusions (1.2 versus 0.9/hip), but more patients received allogeneic blood (23% versus 3.8%). The ASA classification was the only independent predictor for minor complications, major complications, and fat emboli syndrome. We think bilateral single-stage total hip arthroplasties have an acceptable perioperative risk for patients with ASA Class 1 or 2 physical status.
Swanson
Kyle C
KC
Hospital for Special Surgery, New York, NY, USA.
Valle
Alejandro Gonzalez Della
AG
Salvati
Eduardo A
EA
Sculco
Thomas P
TP
Bottner
Friedrich
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods*; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D004620:Embolism, Fat / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000453:epidemiology*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D013577:Syndrome; D016896:Treatment Outcome