Bilateral total hip arthroplasty: one-stage versus two-stage procedure

Taheriazam, Afshin; Mohseni, Gholamreza; Esmailiejah, Ali A.; Safdari, Farshad; Abrishamkarzadeh, Hashem
March 2019
Hip International;Mar2019, Vol. 29 Issue 2, p141
Academic Journal
Background: Despite several studies, controversy has prevailed over the rate of complications following 1-stage and 2-stage bilateral total hip arthroplasty (THA). In the current study, we compare the complications and functional outcomes of 1-stage and 2-stage procedures. Methods: One hundred and eighty patients (ASA class I or II) with bilateral hip osteoarthritis were assigned randomly to two equal groups. The two groups were matched in terms of age and sex. All of the surgeries were performed via the Hardinge approach using uncemented implants. In 2-stage procedures, surgeries were performed with a 6-month to 1-year interval. All patients were evaluated 1 year postoperatively. Results: The Harris Hip Score (HHS) averaged 84.1 and 82.6 in 1-stage and 2-stage groups, respectively (p = 0.528). The hospital stay was significantly longer in the 2-stage group (9.8 days vs. 4.9 days). The cumulative haemoglobin drop and the number of transfused blood units were the same. One patient in each group developed symptomatic deep venous thrombosis which was managed successfully. There was no patient with perioperative death, pulmonary embolism, infection, dislocation, periprosthetic fracture or heterotrophic ossification. No patient required reoperation. Two patients in the 1-stage group developed unilateral temporary peroneal nerve palsy, which was resolved after 3–4 months. Conclusion: 1-stage bilateral THA can be used successfully for patients with bilateral hip disease without increasing the rate of complications. Functional and clinical outcomes are comparable and hospital stay is significantly shorter.


Related Articles

  • The safety and efficacy of one-stage bilateral metal-on-metal hip resurfacing arthroplasty. Nam, Denis; Rebolledo, Brian J.; Su, Edwin P. // Hip International;Jan-Mar2012, Vol. 22 Issue 1, p100 

    The objective of this study was to report the perioperative safety and efficacy of single-stage, bilateral hip resurfacing arthroplasties (HRAs) in 104 patients. The mean preoperative ASA grade was 1.7 ± 0.6, and the mean total operative time was 3 hours and 31 minutes (± 32 mins). 13...

  • Preoperative Erythropoietin Alpha Reduces Postoperative Transfusions in THA and TKA but May Not Be Cost-effective. Bedair, Hany; Yang, Judy; Dwyer, Maureen; McCarthy, Joseph // Clinical Orthopaedics & Related Research;Feb2015, Vol. 473 Issue 2, p590 

    Background: Preoperative erythropoietin alpha (EPO) has been shown to be effective at reducing postoperative blood transfusions in total hip arthroplasty (THA) and total knee arthroplasty (TKA); however, treatment with EPO is associated with additional costs, and it is not known whether these...

  • Function and survival after revision of hip resurfacing. Jaiswal, Anuj; Gilbert, Robin E.; Kumar, Karadi H. Sunil; Carrothers, Andrew D.; Kuiper, Jan-Herman; Richardson, James B. // Hip International;2011, Vol. 21 Issue 5, p610 

    The purpose of this study was to compare functional outcome and survival of isolated acetabular, isolated femoral and both component revision after failure of primary Birmingham Hip Resurfacing. The Oswestry Outcome Centre prospectively collected data on 5000 hip resurfacing between 1997 and...

  • Bilateral simultaneous total hip arthroplasty in a fast track setting. Otte, Kristian S.; Husted, Henrik; Ørsnes, Thue; Kehlet, Henrik // Hip International;Jul-Sep2011, Vol. 21 Issue 3, p336 

    Simultaneous bilateral hip arthroplasty has been reported to have varying results in the literature when performed using conventional postoperative care. Unilateral hip and knee arthroplasty as well as bilateral simultaneous knee arthroplasty may be associated with reduced length of stay and low...

  • Modular Cementless Total Hip Arthroplasty for Hip Infection Sequelae. Seung-Jae Lim; Youn-Soo Park // Orthopedics;Sep2005 Supplement, Vol. 28, ps1063 

    Childhood hip infection may produce significant anatomical deformations leading to the premature onset of secondary osteoarthritis. Total hip arthroplasty (THA)in these patient populations can be technically challenging and has been associated with high complication rates. This article reports...

  • Is homologous blood transfusion a risk factor for infection after hip replacement? Steinitz, Dan; Harvey, Edward J.; Leighton, Ross K.; Petrie, David P. // Canadian Journal of Surgery;Oct2001, Vol. 44 Issue 5, p355 

    Assesses the risk of postoperative infection associated with blood transfusion in patients undergoing total hip arthroplasty. Incidence of infection postoperative; Predictors of postoperative infection; Examination on transfusion and operative time.

  • Correction of severe pelvic obliquity using maximum-width segmental sacropelvic screw fixation: an analysis of 20 neuromuscular scoliosis patients. Awwad, Waleed; Al-Ahaideb, Abdulaziz; Jiang, Liang; Algarni, Abdulrahman; Ouellet, Jean; Harold, Mary; Arlet, Vincent // European Journal of Orthopaedic Surgery & Traumatology;Jul2015 Supplement, Vol. 25, p233 

    Study design: The present study was a retrospective analysis. Objective: The purpose of the study was to evaluate the safety and efficacy of the maximum-width (M-W) segmental sacropelvic fixation technique, comprising iliac screws and/or iliosacral pedicle screws, to correct severe pelvic...

  • Prospective Randomized Evaluation of the Need for Blood Transfusion During Primary Total Hip Arthroplasty with Use of a Bipolar Sealer. Barsoum, Wael K.; Klika, Alison K.; Murray, Trevor G.; Higuera, Carlos; Ho H. Lee; Krebs, Viktor E. // Journal of Bone & Joint Surgery, American Volume;3/16/2011, Vol. 93-A Issue 6, p513 

    Background: Blood loss during total hip arthroplasty can be substantial and may lead to adverse patient outcomes and increased health-care costs. Many blood-management options are available for these procedures. The prurpose of the present study was to test the hemostatic efficacy of a bipolar...

  • Surgical Technique: Arthroscopic Treatment of Heterotopic Ossification of the Hip After Prior Hip Arthroscopy. Ong, Crispin; Hall, Michael; Youm, Thomas // Clinical Orthopaedics & Related Research;Apr2013, Vol. 471 Issue 4, p1277 

    Background: The incidence of heterotopic ossification (HO) after hip arthroscopy reportedly ranges from less than 1.0% to 6.3%. Although open debridement has been described and a few series mention arthroscopic debridement, the techniques for arthroscopic excision of HO have not been described...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics