S Hiranya Kumar, N Vamshikrishna Chand, B A Pradeep, Thippeswamy Darshan, R V Chandan Kumar, D V Harish
{"title":"同期与分期双侧全髋关节置换术的术后疗效比较。","authors":"S Hiranya Kumar, N Vamshikrishna Chand, B A Pradeep, Thippeswamy Darshan, R V Chandan Kumar, D V Harish","doi":"10.13107/jocr.2025.v15.i06.5722","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is an effective orthopedic surgery. Patients who go through the surgery experience better functioning and overall satisfaction with their lives. Other medical ailments like rheumatoid arthritis, ankylosing spondylitis, developmental dysplasia, and avascular femoral head necrosis require both hips to undergo THA. Retrospective studies suggest simultaneous bilateral THA (sim-BTHA) utilizes fewer hospital resources, brings about a shorter length of stay, as well as fewer complications compared to traditional methods, but does seem to have a higher requirement for blood transfusions. Despite the improvements to this procedure, comprehensive comparisons regarding single-institute approaches are sparse, creating an area of need focused on analysing complications, transfusion rates, and overall hospital length stays.</p><p><strong>Aims and objectives: </strong>This study works to evaluate both sim-BTHA and staged bilateral THA (staged-BTHA) with particular concentration on: (1) The variations in complication rates postoperatively, (2) The variations in blood transfusion amounts required postoperatively, (3) The duration of hospital stay in proportional to the surgery.</p><p><strong>Materials and methods: </strong>This study is a prospective cohort study that runs from January 2016 to June 2024 with a target sample size of 89 patients (44 sim-BTHA, 45 staged-BTHA). Patients were divided on the basis of age, gender, diagnosis, and other clinical parameters like ASA grade, comorbidities, hemoglobin, and bone stock, with lower-age, healthier patients in sim-BTHA group. All groups underwent a standard posterolateral approach as well as uniform perioperative protocols. Details including complications, transfusions, and length of stay were retrieved from the medical records and post-operative follow-up period of 3 months.</p><p><strong>Results: </strong>Rates of complications were similar (36.3% sim-BTHA vs. 60% staged-BTHA, P = 0.588). Sim-BTHA was associated with lower medical complications (Gastrointestinal: 9.1% vs. 15.6%). Compared surgical complications were similar; however, deep infections and hematomas occurred only in staged-BTHA (2.2% each). Higher transfusions were seen in sim-BTHA (36.3% vs. 20%, P = 0.086). There was a significant difference in hospital stays with sim-BTHA having shorter stays than staged BTHA (14.4 vs. 28.8 days, P < 0.001). Patients with Sim-BTHA were younger (P < 0.001), had a lesser ASA score (ASA grade 1: 65.9% vs. 40%, P = 0.003), and more diagnosed cases of ankylosing spondylitis (P = 0.002).</p><p><strong>Conclusion: </strong>For younger and fitter patients, Sim-BTHA appears to be safe, with greater complications seen in staged BTHA, increased transfusion needs, and shorter hospital stays. This supports increased usage in ideal candidates.</p>","PeriodicalId":16647,"journal":{"name":"Journal of Orthopaedic Case Reports","volume":"15 6","pages":"223-231"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159649/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of Per-Operative Outcomes between Simultaneous and Staged Bilateral Total Hip Arthroplasties.\",\"authors\":\"S Hiranya Kumar, N Vamshikrishna Chand, B A Pradeep, Thippeswamy Darshan, R V Chandan Kumar, D V Harish\",\"doi\":\"10.13107/jocr.2025.v15.i06.5722\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is an effective orthopedic surgery. Patients who go through the surgery experience better functioning and overall satisfaction with their lives. Other medical ailments like rheumatoid arthritis, ankylosing spondylitis, developmental dysplasia, and avascular femoral head necrosis require both hips to undergo THA. Retrospective studies suggest simultaneous bilateral THA (sim-BTHA) utilizes fewer hospital resources, brings about a shorter length of stay, as well as fewer complications compared to traditional methods, but does seem to have a higher requirement for blood transfusions. Despite the improvements to this procedure, comprehensive comparisons regarding single-institute approaches are sparse, creating an area of need focused on analysing complications, transfusion rates, and overall hospital length stays.</p><p><strong>Aims and objectives: </strong>This study works to evaluate both sim-BTHA and staged bilateral THA (staged-BTHA) with particular concentration on: (1) The variations in complication rates postoperatively, (2) The variations in blood transfusion amounts required postoperatively, (3) The duration of hospital stay in proportional to the surgery.</p><p><strong>Materials and methods: </strong>This study is a prospective cohort study that runs from January 2016 to June 2024 with a target sample size of 89 patients (44 sim-BTHA, 45 staged-BTHA). Patients were divided on the basis of age, gender, diagnosis, and other clinical parameters like ASA grade, comorbidities, hemoglobin, and bone stock, with lower-age, healthier patients in sim-BTHA group. All groups underwent a standard posterolateral approach as well as uniform perioperative protocols. Details including complications, transfusions, and length of stay were retrieved from the medical records and post-operative follow-up period of 3 months.</p><p><strong>Results: </strong>Rates of complications were similar (36.3% sim-BTHA vs. 60% staged-BTHA, P = 0.588). Sim-BTHA was associated with lower medical complications (Gastrointestinal: 9.1% vs. 15.6%). Compared surgical complications were similar; however, deep infections and hematomas occurred only in staged-BTHA (2.2% each). Higher transfusions were seen in sim-BTHA (36.3% vs. 20%, P = 0.086). There was a significant difference in hospital stays with sim-BTHA having shorter stays than staged BTHA (14.4 vs. 28.8 days, P < 0.001). Patients with Sim-BTHA were younger (P < 0.001), had a lesser ASA score (ASA grade 1: 65.9% vs. 40%, P = 0.003), and more diagnosed cases of ankylosing spondylitis (P = 0.002).</p><p><strong>Conclusion: </strong>For younger and fitter patients, Sim-BTHA appears to be safe, with greater complications seen in staged BTHA, increased transfusion needs, and shorter hospital stays. 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引用次数: 0
摘要
全髋关节置换术(THA)是一种有效的骨科手术。接受手术的患者会体验到更好的功能和对生活的总体满意度。其他医学疾病,如类风湿关节炎、强直性脊柱炎、发育不良和无血管性股骨头坏死需要双髋接受THA。回顾性研究表明,与传统方法相比,同时双侧THA (sims - btha)使用的医院资源更少,住院时间更短,并发症也更少,但似乎对输血的要求更高。尽管对这一程序进行了改进,但对单一研究所方法的全面比较很少,这造成了一个需要集中分析并发症、输血率和总体住院时间的领域。目的和目的:本研究旨在评估单侧btha和分阶段双侧btha(分阶段btha),特别关注:(1)术后并发症发生率的变化,(2)术后输血量的变化,(3)住院时间与手术成正比。材料与方法:本研究是一项前瞻性队列研究,研究时间为2016年1月至2024年6月,目标样本量为89例患者(44例sim-BTHA, 45例分期btha)。根据年龄、性别、诊断情况及其他临床参数如ASA分级、合并症、血红蛋白、骨量等进行分组,sim-BTHA组患者年龄较低,健康状况较好。所有组均采用标准的后外侧入路和统一的围手术期方案。从医疗记录和术后3个月的随访中检索并发症、输血和住院时间等详细信息。结果:两组并发症发生率相似(sim-BTHA为36.3%,分期btha为60%,P = 0.588)。Sim-BTHA与较低的医学并发症相关(胃肠道:9.1%对15.6%)。手术并发症比较相似;然而,深度感染和血肿仅发生在分期btha(各2.2%)。sim-BTHA组输血量较高(36.3% vs. 20%, P = 0.086)。sim-BTHA的住院时间比分期BTHA的住院时间短(14.4天对28.8天,P < 0.001)。Sim-BTHA患者更年轻(P < 0.001), ASA评分更低(ASA 1级:65.9% vs. 40%, P = 0.003),诊断为强直性脊柱炎的病例更多(P = 0.002)。结论:对于年轻和健康的患者,Sim-BTHA似乎是安全的,分期BTHA的并发症更大,输血需求增加,住院时间更短。这支持在理想候选中增加使用量。
Comparison of Per-Operative Outcomes between Simultaneous and Staged Bilateral Total Hip Arthroplasties.
Introduction: Total hip arthroplasty (THA) is an effective orthopedic surgery. Patients who go through the surgery experience better functioning and overall satisfaction with their lives. Other medical ailments like rheumatoid arthritis, ankylosing spondylitis, developmental dysplasia, and avascular femoral head necrosis require both hips to undergo THA. Retrospective studies suggest simultaneous bilateral THA (sim-BTHA) utilizes fewer hospital resources, brings about a shorter length of stay, as well as fewer complications compared to traditional methods, but does seem to have a higher requirement for blood transfusions. Despite the improvements to this procedure, comprehensive comparisons regarding single-institute approaches are sparse, creating an area of need focused on analysing complications, transfusion rates, and overall hospital length stays.
Aims and objectives: This study works to evaluate both sim-BTHA and staged bilateral THA (staged-BTHA) with particular concentration on: (1) The variations in complication rates postoperatively, (2) The variations in blood transfusion amounts required postoperatively, (3) The duration of hospital stay in proportional to the surgery.
Materials and methods: This study is a prospective cohort study that runs from January 2016 to June 2024 with a target sample size of 89 patients (44 sim-BTHA, 45 staged-BTHA). Patients were divided on the basis of age, gender, diagnosis, and other clinical parameters like ASA grade, comorbidities, hemoglobin, and bone stock, with lower-age, healthier patients in sim-BTHA group. All groups underwent a standard posterolateral approach as well as uniform perioperative protocols. Details including complications, transfusions, and length of stay were retrieved from the medical records and post-operative follow-up period of 3 months.
Results: Rates of complications were similar (36.3% sim-BTHA vs. 60% staged-BTHA, P = 0.588). Sim-BTHA was associated with lower medical complications (Gastrointestinal: 9.1% vs. 15.6%). Compared surgical complications were similar; however, deep infections and hematomas occurred only in staged-BTHA (2.2% each). Higher transfusions were seen in sim-BTHA (36.3% vs. 20%, P = 0.086). There was a significant difference in hospital stays with sim-BTHA having shorter stays than staged BTHA (14.4 vs. 28.8 days, P < 0.001). Patients with Sim-BTHA were younger (P < 0.001), had a lesser ASA score (ASA grade 1: 65.9% vs. 40%, P = 0.003), and more diagnosed cases of ankylosing spondylitis (P = 0.002).
Conclusion: For younger and fitter patients, Sim-BTHA appears to be safe, with greater complications seen in staged BTHA, increased transfusion needs, and shorter hospital stays. This supports increased usage in ideal candidates.