Single staged bilateral total hip replacement and its outcomes: A cross-sectional study.

Abstract

Background: Bilateral hip disorder is a common finding that can occur in approximately 42% of the population with osteoarthritis. It is estimated that 25% individuals with osteoarthritis requiring total hip replacement (THR) may require a bilateral replacement. This has resulted in the test of the greatest strategy to run single staged bilateral hip replacement while addressing the outcomes to achieve swift and cost-effective patient recovery.

Aim: To assess the outcomes and cost effectiveness of bilateral THR (B/L THR) at our tertiary care hospital.

Methods: Retrospective observational cross- sectional study was undertaken from Jan 2018 to July 2023 to assess the clinical outcomes of patients who underwent single stage B/L THR.

Results: Data of 75 patients were analysed. The mean age was 36 years. Our complication rate was 4.0% including acute coronary syndrome, intra-operative acetabular fracture and paralytic ileus. The re-admission rate was 4%.

Conclusion: The choice of sequential or bilateral hip replacement is controversial. While, our study showed that bilateral hip replacement is safe and cost effective. As surgeons, we were careful in patient selection (low American Society of Anesthesiologist score). Though more than 50% of our B/L THR patients were obese [body mass index (BMI) > 25], our outcomes were equivalent to normal BMI patients with lower risk of complication as well as early ambulation. Systemic complication deep vein thrombosis and pulmonary embolism were handled prophylactively by close monitoring, use of mechanical and pharmacological agents along with anticoagulants. Patients who require THR, often require them bilaterally and single stage replacement thus offers early restoration of an individual into their activities of daily living with minimal complications. Our findings support the use of single-stage B/L THR as a viable option for bilateral hip disorders, having favourable outcomes.