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Published in: International Orthopaedics 11/2013

01-11-2013 | Original Paper

Simultaneous bilateral total hip arthroplasties do not lead to higher complication or allogeneic transfusion rates compared to unilateral procedures

Authors: Sergio Romagnoli, Sara Zacchetti, Paolo Perazzo, Francesco Verde, Giuseppe Banfi, Marco Viganò

Published in: International Orthopaedics | Issue 11/2013

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Abstract

Purpose

About 20 % of patients undergoing a primary total hip arthroplasty could undergo a second contralateral procedure within five years. The possibility to perform simultaneous bilateral hip replacements instead of two-stage surgery could reduce hospitalisation time and patient management costs, but concerns exist because of risks related to massive blood loss and possible increase in complication rates. The purpose of this study is to assess the veracity of these concerns.

Methods

Parameters like blood loss, transfused blood units, total hospital length of stay (surgical and rehabilitation) and presence of in-hospital complications were collected from surgery reports of two different groups of patients. The first group comprised patients undergoing simultaneous bilateral total hip arthroplasty (n = 63), while the second group consisted of patients undergoing unilateral surgery (n = 97). Occurrence of complications within six post-operative months was assessed by phone interview.

Results

No differences were observed in complication, revision and mortality rates between the study groups. On the contrary, blood loss was significantly higher in the bilateral group, but the application of appropriate transfusion protocols reduced the use of allogeneic blood transfusion to the levels recorded for unilateral patients. Moreover, the difference in length of hospital stay (about two days) between the two groups was not clinically relevant.

Conclusions

Our data show that simultaneous bilateral procedures do not lead to higher complication or allogeneic transfusion rates in comparison to unilateral hip replacement, and that, in cases of bilateral disease, they could significantly reduce the total length of hospital stay and, therefore, patient management costs.
Literature
1.
go back to reference Mannoni A, Briganti MP, Di Bari M, Ferrucci L, Costanzo S, Serni U, Masotti G, Marchionni N (2003) Epidemiological profile of symptomatic osteoarthritis in older adults: a population based study in Dicomano, Italy. Ann Rheum Dis 62(6):576–578PubMedCrossRef Mannoni A, Briganti MP, Di Bari M, Ferrucci L, Costanzo S, Serni U, Masotti G, Marchionni N (2003) Epidemiological profile of symptomatic osteoarthritis in older adults: a population based study in Dicomano, Italy. Ann Rheum Dis 62(6):576–578PubMedCrossRef
2.
go back to reference Mont MA, Mitzner DL, Jones LC, Hungerford DS (1995) History of the contralateral knee after primary knee arthroplasty for osteoarthritis. Clin Orthop Relat Res 321:145–150PubMed Mont MA, Mitzner DL, Jones LC, Hungerford DS (1995) History of the contralateral knee after primary knee arthroplasty for osteoarthritis. Clin Orthop Relat Res 321:145–150PubMed
3.
go back to reference Jones CA, Pohar S (2012) Health-related quality of life after total joint arthroplasty a scoping review. Clin Geriatr Med 28(3):395–429PubMedCrossRef Jones CA, Pohar S (2012) Health-related quality of life after total joint arthroplasty a scoping review. Clin Geriatr Med 28(3):395–429PubMedCrossRef
4.
go back to reference Ritter MA, Carr K, Herbst SA, Eizember LE, Keating EM, Faris PM, Meding JB (1996) Outcome of the contralateral hip following total hip arthroplasty for osteoarthritis. J Arthroplasty 11(3):242–246PubMedCrossRef Ritter MA, Carr K, Herbst SA, Eizember LE, Keating EM, Faris PM, Meding JB (1996) Outcome of the contralateral hip following total hip arthroplasty for osteoarthritis. J Arthroplasty 11(3):242–246PubMedCrossRef
5.
go back to reference Sayeed SA, Johnson AJ, Jaffe DE, Mont MA (2012) Incidence of contralateral THA after index THA for osteoarthritis. Clin Orthop 470(2):535–540PubMedCrossRef Sayeed SA, Johnson AJ, Jaffe DE, Mont MA (2012) Incidence of contralateral THA after index THA for osteoarthritis. Clin Orthop 470(2):535–540PubMedCrossRef
6.
go back to reference Goker B, Doughan AM, Schnitzer TJ, Block JA (2000) Quantification of progressive joint space narrowing in osteoarthritis of the hip: longitudinal analysis of the contralateral hip after total hip arthroplasty. Arthritis Rheum 43(5):988–994PubMedCrossRef Goker B, Doughan AM, Schnitzer TJ, Block JA (2000) Quantification of progressive joint space narrowing in osteoarthritis of the hip: longitudinal analysis of the contralateral hip after total hip arthroplasty. Arthritis Rheum 43(5):988–994PubMedCrossRef
7.
go back to reference Husted H, Overgaard S, Laursen JO, Hindsø K, Hansen LN, Knudsen HM, Mossing NB (1996) Need for bilateral arthroplasty for coxarthrosis. 1,477 replacements in 1,199 patients followed for 0–14 years. Acta Orthop Scand 67(5):421–423PubMedCrossRef Husted H, Overgaard S, Laursen JO, Hindsø K, Hansen LN, Knudsen HM, Mossing NB (1996) Need for bilateral arthroplasty for coxarthrosis. 1,477 replacements in 1,199 patients followed for 0–14 years. Acta Orthop Scand 67(5):421–423PubMedCrossRef
8.
go back to reference Lorenze M, Huo MH, Zatorski LE, Keggi KJ (1998) A comparison of the cost effectiveness of one-stage versus two-stage bilateral total hip replacement. Orthopedics 21(12):1249–1252PubMed Lorenze M, Huo MH, Zatorski LE, Keggi KJ (1998) A comparison of the cost effectiveness of one-stage versus two-stage bilateral total hip replacement. Orthopedics 21(12):1249–1252PubMed
9.
go back to reference Pfeil J, Höhle P, Rehbein P (2011) Bilateral endoprosthetic total hip or knee arthroplasty. Dtsch Arztebl Int 108(27):463–468PubMed Pfeil J, Höhle P, Rehbein P (2011) Bilateral endoprosthetic total hip or knee arthroplasty. Dtsch Arztebl Int 108(27):463–468PubMed
10.
go back to reference Bhan S, Pankaj A, Malhotra R (2006) One- or two-stage bilateral total hip arthroplasty: a prospective, randomised, controlled study in an Asian population. J Bone Joint Surg Br 88(3):298–303PubMed Bhan S, Pankaj A, Malhotra R (2006) One- or two-stage bilateral total hip arthroplasty: a prospective, randomised, controlled study in an Asian population. J Bone Joint Surg Br 88(3):298–303PubMed
11.
go back to reference Alfaro-Adrián J, Bayona F, Rech JA, Murray DW (1999) One- or two-stage bilateral total hip replacement. J Arthroplasty 14(4):439–445PubMedCrossRef Alfaro-Adrián J, Bayona F, Rech JA, Murray DW (1999) One- or two-stage bilateral total hip replacement. J Arthroplasty 14(4):439–445PubMedCrossRef
12.
go back to reference Parvizi J, Tarity TD, Sheikh E, Sharkey PF, Hozack WJ, Rothman RH (2006) Bilateral total hip arthroplasty: one-stage versus two-stage procedures. Clin Orthop 453:137–141PubMedCrossRef Parvizi J, Tarity TD, Sheikh E, Sharkey PF, Hozack WJ, Rothman RH (2006) Bilateral total hip arthroplasty: one-stage versus two-stage procedures. Clin Orthop 453:137–141PubMedCrossRef
13.
go back to reference Trojani C, d’Ollonne T, Saragaglia D, Vielpeau C, Carles M, Prudhon JL et al (2012) One-stage bilateral total hip arthroplasty: functional outcomes and complications in 112 patients. Orthop Traumatol Surg Res 98(6 Suppl):S120–S123PubMedCrossRef Trojani C, d’Ollonne T, Saragaglia D, Vielpeau C, Carles M, Prudhon JL et al (2012) One-stage bilateral total hip arthroplasty: functional outcomes and complications in 112 patients. Orthop Traumatol Surg Res 98(6 Suppl):S120–S123PubMedCrossRef
14.
go back to reference Aghayev E, Beck A, Staub LP, Dietrich D, Melloh M, Orljanski W, Röder C (2010) Simultaneous bilateral hip replacement reveals superior outcome and fewer complications than two-stage procedures: a prospective study including 1819 patients and 5801 follow-ups from a total joint replacement registry. BMC Musculoskelet Disord 11:245PubMedCrossRef Aghayev E, Beck A, Staub LP, Dietrich D, Melloh M, Orljanski W, Röder C (2010) Simultaneous bilateral hip replacement reveals superior outcome and fewer complications than two-stage procedures: a prospective study including 1819 patients and 5801 follow-ups from a total joint replacement registry. BMC Musculoskelet Disord 11:245PubMedCrossRef
15.
go back to reference Bangjian H, Peijian T, Ju L (2012) Bilateral synchronous total hip arthroplasty for ankylosed hips. Int Orthop 36(4):697–701PubMedCrossRef Bangjian H, Peijian T, Ju L (2012) Bilateral synchronous total hip arthroplasty for ankylosed hips. Int Orthop 36(4):697–701PubMedCrossRef
16.
go back to reference Berend ME, Ritter MA, Harty LD, Davis KE, Keating EM, Meding JB, Thong AE (2005) Simultaneous bilateral versus unilateral total hip arthroplasty: an outcomes analysis. J Arthroplasty 20(4):421–426PubMedCrossRef Berend ME, Ritter MA, Harty LD, Davis KE, Keating EM, Meding JB, Thong AE (2005) Simultaneous bilateral versus unilateral total hip arthroplasty: an outcomes analysis. J Arthroplasty 20(4):421–426PubMedCrossRef
17.
go back to reference Berend KR, Lombardi AV, Adams JB (2007) Simultaneous vs staged cementless bilateral total hip arthroplasty: perioperative risk comparison. J Arthroplasty 22(6 Suppl 2):111–115 Berend KR, Lombardi AV, Adams JB (2007) Simultaneous vs staged cementless bilateral total hip arthroplasty: perioperative risk comparison. J Arthroplasty 22(6 Suppl 2):111–115
18.
go back to reference Salvati EA, Hughes P, Lachiewicz P (1978) Bilateral total hip-replacement arthroplasty in one stage. J Bone Joint Surg Am 60(5):640–644PubMed Salvati EA, Hughes P, Lachiewicz P (1978) Bilateral total hip-replacement arthroplasty in one stage. J Bone Joint Surg Am 60(5):640–644PubMed
19.
go back to reference Garbe E, Boivin J, LeLorier J, Suissa S (1998) Selection of controls in database case-control studies: glucocorticoids and the risk of glaucoma. J Clin Epidemiol 51(2):129–135PubMedCrossRef Garbe E, Boivin J, LeLorier J, Suissa S (1998) Selection of controls in database case-control studies: glucocorticoids and the risk of glaucoma. J Clin Epidemiol 51(2):129–135PubMedCrossRef
20.
go back to reference Gee AO, Garino JP, Lee G (2011) Autologous blood reinfusion in patients undergoing bilateral total hip arthroplasty. J Orthop Surg (Hong Kong) 19(2):181–184 Gee AO, Garino JP, Lee G (2011) Autologous blood reinfusion in patients undergoing bilateral total hip arthroplasty. J Orthop Surg (Hong Kong) 19(2):181–184
21.
go back to reference Perazzo P, Viganò M, de Girolamo L, Verde F, Vinci A, Banfi G, Romagnoli S (2013) Blood management and transfusion strategies in 600 patients undergoing total joint arthroplasty: an analysis of pre-operative autologous blood donation. Blood Transfus 7:1–7. doi:10.2450/2013.0197-12 Perazzo P, Viganò M, de Girolamo L, Verde F, Vinci A, Banfi G, Romagnoli S (2013) Blood management and transfusion strategies in 600 patients undergoing total joint arthroplasty: an analysis of pre-operative autologous blood donation. Blood Transfus 7:1–7. doi:10.​2450/​2013.​0197-12
22.
go back to reference Horstmann WG, Kuipers BM, Slappendel R, Castelein RM, Kollen BJ, Verheyen CC (2012) Postoperative autologous blood transfusion drain or no drain in primary total hip arthroplasty? A randomised controlled trial. Int Orthop 36:2033–2039PubMedCrossRef Horstmann WG, Kuipers BM, Slappendel R, Castelein RM, Kollen BJ, Verheyen CC (2012) Postoperative autologous blood transfusion drain or no drain in primary total hip arthroplasty? A randomised controlled trial. Int Orthop 36:2033–2039PubMedCrossRef
23.
go back to reference Sukeik M, Alshryda S, Haddad FS, Mason JM (2011) Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement. J Bone Joint Surg Br 93(1):39–46PubMed Sukeik M, Alshryda S, Haddad FS, Mason JM (2011) Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement. J Bone Joint Surg Br 93(1):39–46PubMed
24.
go back to reference Kim TK, Chang CB, Kang YG, Seo ES, Lee JH, Yun JH, Lee SH (2013) Clinical value of tranexamic acid in unilateral and simultaneous bilateral TKAs under a contemporary blood-saving protocol: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2492-1 Kim TK, Chang CB, Kang YG, Seo ES, Lee JH, Yun JH, Lee SH (2013) Clinical value of tranexamic acid in unilateral and simultaneous bilateral TKAs under a contemporary blood-saving protocol: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-013-2492-1
25.
go back to reference Eggli S, Huckell CB, Ganz R (1996) Bilateral total hip arthroplasty: one stage versus two stage procedure. Clin Orthop Relat Res 328:108–118PubMedCrossRef Eggli S, Huckell CB, Ganz R (1996) Bilateral total hip arthroplasty: one stage versus two stage procedure. Clin Orthop Relat Res 328:108–118PubMedCrossRef
Metadata
Title
Simultaneous bilateral total hip arthroplasties do not lead to higher complication or allogeneic transfusion rates compared to unilateral procedures
Authors
Sergio Romagnoli
Sara Zacchetti
Paolo Perazzo
Francesco Verde
Giuseppe Banfi
Marco Viganò
Publication date
01-11-2013
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 11/2013
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2015-1

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