Single stage bilateral total hip arthroplasty - 10 years of experience

Abstract

Background/Aim. Coxarthrosis is a chronic degenerative joint disorder which occurs in approximately 4% of population, and bilateral occurrence is estimated at 42%. Patients with bilateral coxarthrosis can undergo bilateral hip replacement in one or two stage procedure. Aim of this article was to present our experience in simultaneous bilateral hip arthroplasty, and to recommend it in patients with adequate indications. Methods. We processed data for 113 patients of both genders, operated at the Clinic for Orthopedic Surgery and Traumatology of the Military Medical Academy in Belgrade, Serbia from 2005 until 2015 where single stage bilateral hip arthroplasty was performed. Identical operative technique was applied in all patients as well as standard antibiotic and thromboprophylactic treatment. Follow-up period was 30 days postoperatively. Results. Mean age of patients was 56 ? 10.2 years, whereby 45 (39.8%) of them were males and 68 (60.2%) females. Primary coxarthrosis was etiologic factor for the majority of patients, 69 (61.1%). Postoperative hospitalization duration was 10.3 days on average (range from 3 to 34 days). We noticed the following complications: one luxation of the endoprosthesis, one deep infection and one thrombosis of the leg. There was no mortality. Majority of operated patients were grouped as the American Society of Anesthesiologists (ASA) scores 1-3. Mean blood transfusion was 1,275 mL (range from 300 to 2,830 mL). Conclusion. One stage bilateral hip arthroplasty can be performed routinely and safely in facilities with possibility for interdisciplinary approach and adequate selection of patients. Data from our study which indicate significantly increased need for blood substitution, emphasize the need to introduce contemporary perioperative blood loss management principles. The rate of complications observed in our study was within rates published in the literature concerning hip arthroplasty.