Long-Term Results Of Staged Bilateral Hip Arthroplasty

Objectives. Bilateral total hip replacement is an option for patients suffering from osteoarthritis in both hips with no effective nonsurgical treatment. Question about optimal time interval after the first arthroplasty remains unclear. Complications after surgery can extend patients’ hospitalization time and result in additional costs for hospitals and patients. The aim of the study was to discover if there is a difference in the timing of the second surgery, clinical results and adverse event rate.
Materials and Methods. The retrospective analysis of 162 patients (324 primary staged bilateral total hip arthroplasties) was made. All surgeries were performed by one senior surgeon (1992-2017) at a single hospital. We calculated months between both arthroplasties for every patient. In addition, an analysis of demographics, hospitalization time, transfusion rate, complications was conducted. Patients were split into three groups depending on the timing of the second arthroplasty: (1) from 2 weeks to 5.9 months; (2) from 6 months to 11.9 months; (3) from 12 months to 24 months.
Results. Groups had similar demographic distribution and comorbidity rates. Most popular preoperative diagnosis was bilateral coxarthrosis (55,8% 1st group; 60,3% 2nd group; 67,6% 3rd group). Transfusion rate, the median volume of red blood cell mass, allogenic blood transfusion rate, hospital adverse event rate were not significantly different between all groups. Median hospital stay was similar in all three groups (14 days vs 14 days vs 12 days). The difference in median operation time did not reach a statistically significant level. Results of all three groups were similar; however, cementless endoprosthesis was much often used in patients with a shorter time interval between arthroplasties, but the percentage of cemented and hybrid prosthesis, on the contrary, increased with time interval till the second arthroplasty.
Conclusions. The study demonstrates that staging of the second arthroplasty does not influence hospital adverse event rate and perioperative outcome. In addition, demographics, hospitalization time, complication and transfusion rate were similar among all three groups.