Bilateral total hip arthroplasty: one-stage versus two-stage procedures.
We compared the outcomes of bilateral total hip arthroplasty performed as a one-stage or two-stage procedure. We retrospectively identified 196 patients (392 hips) with bilateral arthritis of the hip who underwent total hip arthroplasties: 98 patients (196 hips) as a one-stage procedure (one-stage group) and 98 (196 hips) as a two-stage procedure (two-stage group). All patients had uncemented components implanted under spinal anesthesia and had the same postoperative rehabilitation protocol. Both groups' functional outcomes were similar. The mean preoperative hemoglobin was 12.6 g/dL in the one-stage group and 12.9 g/dL in the two-stage group. The mean cumulative blood transfusion was 2.6 units in the one-stage group and 3.5 units in the two-stage group. Patients in the two-stage group had more complications, most commonly anemia and wound drainage. The total mean hospital stay was longer in the two-stage group (8.1 days; range, 5-39 days) compared with the one-stage group (4.3 days; range, 3-11 days). The mean total expenses were higher in the two-stage group (dollar 64,600) compared with the one-stage group (dollar 45,900). Young and healthy patients may be candidates for one-stage bilateral total hip arthroplasty without an increase in complications and with lower costs.
Parvizi
Javad
J
Rothman Institute of Orthopedics, Thomas Jefferson Hospital, Philadelphia, PA, USA. parvj@aol.com
Tarity
T David
TD
Sheikh
Ednan
E
Sharkey
Peter F
PF
Hozack
William J
WJ
Rothman
Richard H
RH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001803:Blood Transfusion; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D016896:Treatment Outcome