Bilateral Total Hip Arthroplasty: One-Stage or Two-Stage

The aim of this study is to present our experience with two-stage reimplantation in the management of the infected hip arthroplasty. Between January 1993 and December 2001 the replacement of the total hip arthroplasty in two stages was performed in 18 patients. There were 7 male and 11 female patients and the average age was 62 years. The mean follow-up after revision was 3.5 years. The mean postoperative Harris Hip Score averaged 78 (50–96) points. None of 18 patients had a recurrence of the infection. Two-stage reconstruction of the infected hip is preferred to one-stage exchange arthroplasty at our department because of higher rate of eradication of the infection.

Download Full-text

One-stage Versus Two-stage Bilateral Autophor Ceramic Total Hip Arthroplasty

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-198503000-00018 ◽

1985 ◽

Vol &NA; (193) ◽

pp. 141???145 ◽

Cited By ~ 2

Author(s):

CHUN-HSIUNG SHIH ◽

WEI-BIN HO

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Stage Versus ◽

Two Stage ◽

Total Hip ◽

One Stage

Download Full-text

Thirty patients with one-stage hip arthroplasty and multiple drilling decompression for bilateral osteonecrosis of the femoral head:outcomes at two-year follow up

10.21203/rs.2.12958/v1 ◽

2019 ◽

Author(s):

Lu Ding ◽

Yu-Hang Gao ◽

Shi Zhang ◽

Yi-Fan Huang ◽

Jian-Guo Liu ◽

...

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Internal Rotation ◽

Hip Arthroplasty ◽

External Rotation ◽

Radiographic Evaluation ◽

Two Stage ◽

Total Hip ◽

One Stage ◽

Significant Difference

Abstract Background: To investigate the postoperative outcome of decompresed hip following contralateral replacement in patients with bilateral osteonecrosis of the femoral head (ONFH). M ethods: This study retrospectively reviewed 30 patients with bilateral ONFH who underwent one-stage total hip arthroplasty (THA) and multiple drilling decompression from February 2014 to February 2016. For all patients, alendronate was prescribed. Postoperative Harris Hip Scores (HHSs), Oxford Hip Scores (OHSs), Self-Administered Patient Satisfaction (SAPS), hip internal and external rotation angles, and the time of one-leg standing were evaluated. All patients were followed up for an average of 30.33 months (ranged from 8 months to 48 months). Results: Twenty-four patients had no progression or collapse on radiographic evaluation within 2 years postoperatively. The following scores of the decompressed sides were significantly lower than those of the replaced sides: HHSs (mean: 96.5 versus 98.25, P <0.05), SAPS (mean: 96.35 versus 99.48, P <0.001), internal rotation (mean: 27.58° versus 30.50°, P <0.05), and the time of single-leg standing (mean: 24.17 s versus 31.83 s, P <0.05). There was no significant difference in OHSs and external rotation between the sides. The remaining 6 patients underwent two-stage THA on the decompressed sides within 2 years. Four of them underwent THA for severe pain and femoral head collapse. The other 2 patients showed no progression on radiographic evaluation but complained of an uncomfortable feeling in the joint. Conclusions: One-stage THA and multiple drilling decompression are effective surgical procedures for bilateral ONFH at different stages. However, a few patients with no progression on radiographic evaluation may require two-stage THA on the decompressed sides because of more pain, poorer internal rotation, and weaker gluteal muscle strength when compared with the replaced sides. Keywords: osteonecrosis of the femoral head, postoperative satisfaction, total hip arthroplasty, multiple drilling decompression

Download Full-text

Similar Risk of Re-Revision in Patients after One- or Two-Stage Surgical Revision of Infected Total Hip Arthroplasty: An Analysis of Revisions in the Swedish Hip Arthroplasty Register 1979–2015.

Journal of Clinical Medicine ◽

10.3390/jcm8040485 ◽

2019 ◽

Vol 8 (4) ◽

pp. 485 ◽

Cited By ~ 9

Author(s):

Svensson ◽

Rolfson ◽

Kärrholm ◽

Mohaddes

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Cox Regression ◽

Rank Test ◽

Two Stage ◽

Arthroplasty Register ◽

Cox Regression Analysis ◽

Total Hip ◽

One Stage ◽

The One

Late chronic infection is a devastating complication after total hip arthroplasty (THA) and is often treated with surgery. The one-stage surgical procedure is believed to be the more advantageous from a patient and cost perspective, but there is no consensus on whether the one- or two-stage procedure is the better option. We analysed the risk for re-revision in infected primary THAs repaired with either the one- or two-stage method. Data was obtained from the Swedish Hip Arthroplasty Register and the study groups were patients who had undergone a one-stage (n = 404) or two-stage (n = 1250) revision due to infection. Risk of re-revision was analysed using Kaplan–Meier analysis with log-rank test and Cox regression analysis. The cumulative survival rate was similar in the two groups at 15 years after surgery (p = 0.1). Adjusting for covariates, the risk for re-revision due to all causes did not differ between patients who were operated on with the one- or two-stage procedure (Hazard Ratio (HR) = 0.9, 95% Confidence Interval (C.I.) = 0.7–1.2, p = 0.5). The risk for re-revision due to infection (HR = 0.7m, 95% C.I. = 0.4–1.1, p = 0.2) and aseptic loosening (HR = 1.2, 95% C.I. = 0.8–1.8, p = 0.5) was similar. This study could not determine whether the one-stage method was inferior in cases when the performing surgeons chose to use the one-stage method.

Download Full-text

Comparison of One-Stage Revision With Antibiotic Cement Versus Two-Stage Revision Results for Infected Total Hip Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2013.02.037 ◽

2013 ◽

Vol 28 (8) ◽

pp. 66-70 ◽

Cited By ~ 45

Author(s):

Ho-Rim Choi ◽

Young-Min Kwon ◽

Andrew A. Freiberg ◽

Henrik Malchau

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Two Stage ◽

Total Hip ◽

Antibiotic Cement ◽

One Stage

Download Full-text

Cementless one-stage bilateral total hip arthroplasty in osteoarthritis patients: functional outcomes and complications

Orthopedic Reviews ◽

10.4081/or.2017.6897 ◽

2017 ◽

Vol 9 (2) ◽

Cited By ~ 2

Author(s):

Afshin Taheriazam ◽

Amin Saeidinia

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Functional Outcomes ◽

Hip Osteoarthritis ◽

Harris Hip Score ◽

Superficial Infection ◽

Total Hip ◽

One Stage ◽

The Mean ◽

Hardinge Approach

Total hip arthroplasty (THA) is one of the successful and cost-benefit surgical treatments. One-stage bilateral THA (BTHA) has a large number of advantages, although there are concerns about the higher complications in this procedure. Aim of our study was to evaluate the complications and outcomes of cementless one-stage BTHA in osteoarthritis patients. A total of 147 patients from 2009 till 2012, underwent one-stage BTHA in Milad and Erfan hospitals, Tehran, Iran. A prospective analysis of the functional outcomes and complications of one-stage BTHA through Hardinge approach in patients with osteoarthritis was performed. We evaluated all patients clinically and radiologically with serial followups. A clinical hip score based upon the modified Harris Hip Score (MHHS) was performed preoperatively and again postoperatively. During the period of study 89 men (60.5%) and 58 women (39.4%) with a mean age of 54.67±7.08 years at the time of presentation were recruited. The mean surgical time was 2.8±0.25 hrs. The mean hospital stay was 3.83±0.65 days. Hemoglobin level decreased significantly after operation (P=0.038). There was two deep venous thromboses, one superficial infection and one temporal proneal palsy but no pulmonary embolism, dislocation, periprosthetic fracture or heterotrophic ossification. The mean preoperative MHHS score was 41.64±5.42 in patients. MHHS score improved to 89.26±4.68 in the last followup (P=0.0001). Our results recommended the use of cementless one-stage BTHA through Hardinge approach in patients with bilateral hip osteoarthritis.

Download Full-text

One-Stage Bilateral Total Hip Arthroplasty. Modern Representations and Our Experience

10.37647/0132-2486-2020-106-3-52-62 ◽

2020 ◽

Vol 106 (3) ◽

pp. 52-62

Author(s):

O.M. Kosiakov ◽

P.V. Bulych ◽

K.O. Hrebennikov ◽

A.V. Myloserdov ◽

Ye. V. Tuz ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Surgical Intervention ◽

Joint Damage ◽

Cost Effective ◽

Modern Medicine ◽

Postoperative Rehabilitation ◽

Surgical Interventions ◽

Total Hip ◽

One Stage

Summary. Relevance. Total hip arthroplasty remains one of the most successful and cost-effective surgical interventions in modern medicine. This is proven by the ever-growing number of total arthroplasties worldwide, which reached 650,000 implantations in Europe only in 2018. In 2024, this number is expected to be 730,000 [1]. According to experts, from 15 to 25 percent of patients need a bilateral procedure [2, 8]. The experience of our Center allows us to recommend a successful one-stage replacement of both hip joints for patients with a number of medical and social comorbidities. Objective. The study is set out to highlight the possibilities of performing simultaneous bilateral arthroplasty of the hip joint in a group of patients with bilateral joint damage, as well as to substantiate the economic, medical and social benefits of this surgical intervention. Materials and Methods. We have analyzed the data from publications of our foreign colleagues. We also present our own observations – more than 100 cases over the past 11 years (2008-2019). Results. Based on data from foreign publications and our own observations, the undoubted advantages, features and limitations of this type of surgical intervention are shown. Complex cases of bilateral joint damage and the results of one-stage surgical treatment have been demonstrated. Conclusions. One-stage bilateral hip arthroplasty is the method of choice for symmetric lesions and should take its rightful place in the arsenal of modern orthopedics clinics. We continue to advocate simultaneous bilateral hip replacement for a selected group of healthy patients ≤65 years old. Thoughtful preoperative planning, surgical intervention lasting up to 90 minutes on each joint, careful postoperative monitoring, strictly controlled prevention of thromboembolic complications and active postoperative rehabilitation provide our patients with quick and safe functional recovery.

Download Full-text