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One-stage bilateral total hip arthroplasty: Functional outcomes and complications in 112 patients - 25/09/12

Doi : 10.1016/j.otsr.2012.06.008 
C. Trojani a, , T. d’Ollonne a, D. Saragaglia b, C. Vielpeau c, M. Carles a, J.-L. Prudhon d

the French Society for the Hip and Knee (SFHG)1

  56, rue Boissonade, 75014 Paris, France.

a Department of Orthopaedics and Sports Trauma, De l’Archet Hospital, Nice Teaching Medical Center, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France 
b Department of Orthopaedics and Sports Trauma, South Hospital, Grenoble Teaching Medical Center, avenue de Kimberly, 38434 Echirolles, France 
c Department of Orthopaedics and Traumatology, Côte de Nacre Hospital, Caen Teaching Medical Center, avenue de la Côte de Nacre, 14033 Caen, France 
d Cedars Private Hospital, 48, avenue de Grugliasco, 38130 Echirolles, France 

Corresponding author. Tel.: +33 4 92 03 64 97/+33 4 92 03 61 31; fax: +33 4 92 03 59 62.

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Summary

Background

Advantages of one-stage bilateral total hip arthroplasty (THA) include a single hospital stay, a shorter rehabilitation time, and decreased management costs per patient. However, concern about a possible increase in the perioperative complication rate has limited the use of this strategy. Here, our objectives were to evaluate morbidity and mortality, as well as functional outcomes, in patients managed with one-stage bilateral THA.

Hypothesis

The complication rate after one-stage bilateral THA is not significantly different from that after unilateral THA.

Materials and methods

Four French surgical centres participated in a retrospective observational study of patients managed with one-stage bilateral THA. The 112 included patients (55 women) had a mean age of 59years (range, 22–84) and a mean follow-up of 30months (6–103).

Results

Mean hospital stay length was 10.8days (6–27), mean operative time was 162minutes (95–270), and mean haemoglobin levels were 14.3g/dL preoperatively and 10.1g/dL postoperatively. No perioperative deaths were recorded. Deep vein thrombosis occurred in eight (7.1%) patients and pulmonary embolism in six (5.4%). The Merle d’Aubigné score improved from 9.25±2.9 (3–16) preoperatively to 17.5±1 (14–18) at last follow-up. All but three patients (109/112, 97%) said they would choose the same operation again and 102/112 (91%) said they would recommend it to a family member.

Discussion

The results of this multicentre retrospective study indicate that one-stage bilateral THA is a valid alternative to two-stage bilateral THA in ASA 1 and 2 patients with a preoperative haemoglobin level of about 14g/L. The major complication rate was 7.1%, which was slightly higher than after unilateral THA, and the main complications were deep vein thrombosis and pulmonary embolism.

Level of evidence

Level IV (multicentre retrospective observational study).

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Keywords : Bilateral total hip arthroplasty, One-stage surgery, Complications


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© 2012  Publicado por Elsevier Masson SAS.
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Vol 98 - N° 6S

P. S120-S123 - octobre 2012 Regresar al número
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