title: Bilateral Total Hip Arthroplasty: 1-Stage or 2-Stage? A Meta-Analysis.
abstract: Total hip arthroplasty (THA) is one of the most successful orthopedic surgeries performed in the last 50 years. However, controversies still exist between conducting 1- or 2-stage bilateral THA.
  
  
  
  Using PubMed, Ovid, Embase, and Cochrane library databases, we searched for papers written between January 1995 and October 2015 that contained the following search terms: "one-stage or two-stage" or "simultaneous or staged," and "hip" and "arthroplasty or replacement." A meta-analysis was conducted with the collected pooled data about major and minor systemic complications, surgical complications, and other perioperative data associated with 1- and 2-stage bilateral THA. Statistical analysis was performed by the Mantel-Haenszel method, and the fixed effect model was used to analyze data.
  
  
  
  There were 13 studies with 17,762 patients who underwent 1-stage bilateral THA and 46,147 patients who underwent 2-stage bilateral THA. One-stage bilateral THA had a lower risk of major systemic complications, less deep venous thrombosis, and shorter operative time compared with 2-stage bilateral THA. There were no significant differences in death, pulmonary embolism, cardiovascular complication, infections, minor complications, and other surgical complications between procedures.
  
  
  
  One-stage bilateral THA was superior to 2-stage bilateral THA in terms of major systemic complication, deep venous thrombosis, and surgical time compared with 2-stage bilateral THA. However, this study does not encourage performing 1-stage over 2-stage bilateral THA. Higher evidence level studies are necessary for further analysis.
authors: Orthopedics Department, Beijing Jishuitan Hospital, Beijing, China.
authors: Hongyi
authors: H
authors: Shao
authors: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors: Chi-Lung
authors: CL
authors: Chen
authors: Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors: Mitchell G
authors: MG
authors: Maltenfort
authors: Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors: Camilo
authors: C
authors: Restrepo
authors: Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors: Richard H
authors: RH
authors: Rothman
authors: Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors: Antonia F
authors: AF
authors: Chen
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000401:mortality*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006801:Humans; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology*; D011655:Pulmonary Embolism / Q000209:etiology*; D020246:Venous Thrombosis / Q000209:etiology*
keywords: deep vein thrombosis; meta-analysis; pulmonary embolism; staged arthroplasty; total hip arthroplasty