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

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.

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Simultaneous bilateral minimally invasive total hip arthroplasty: A comprehensive review of the literature

Orthopedic Reviews ◽

10.4081/or.2018.7677 ◽

2018 ◽

Vol 10 (3) ◽

Author(s):

Michael-Alexander Malahias ◽

Kulapat Chulsomlee ◽

Fritz Thorey

Keyword(s):

Clinical Trials ◽

Total Hip Arthroplasty ◽

Minimally Invasive ◽

Hip Arthroplasty ◽

Hip Osteoarthritis ◽

Operation Time ◽

Postoperative Rehabilitation ◽

Total Hip ◽

One Stage ◽

Transfusion Requirements

Several studies have reported that minimally- invasive total hip arthroplasty (MISTHA) may significantly reduce postoperative pain and results in faster postoperative rehabilitation when compared with the traditional lateral or posterior approach. Regarding bilateral hip osteoarthritis, there is still no consensus whether simultaneous bilateral MIS-THA can be established as the treatment of choice. Therefore, we searched the international databases of Pubmed, Medline, and Cochrane Database of Systematic Reviews using the key words minimally invasive bilateral total hip arthroplasty. From the initial 23 articles we found five clinical studies which met our inclusion criteria. From the perspective of possible intra- and postoperative complications, one-stage bilateral MIS THA was equally safe or safer than two-stage interventions. In addition, from a clinical outcome perspective, the one-stage procedure can be considered to be preferable. Higher blood transfusion requirements, which were expected following the standard bilateral simultaneous THA, seemed to be minimized with the simultaneous bilateral MIS THA. The supine position of the patient minimized the mean operation time. Approaches using the lateral decubitus position of the patient should be avoided in simultaneous bilateral THA due to the increased operation time. There is a lack of randomized, controlled clinical trials, comparing simultaneous bilateral MIS THA with staged bilateral MIS THA. Although simultaneous bilateral MIS THA seems to be efficacious, cost-effective and safe, more clinical trials are required to establish its superiority over the sequential MIS THA.

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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.

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Identification of Critical Genes and lncRNAs in Osteolysis after Total Hip Arthroplasty and Osteoarthritis by RNA Sequencing

BioMed Research International ◽

10.1155/2021/6681925 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Guang Yang ◽

Kai Tang ◽

Li Qiao ◽

Yixin Li ◽

Shui Sun

Keyword(s):

Total Hip Arthroplasty ◽

Effective Treatment ◽

Rna Sequencing ◽

Hip Arthroplasty ◽

Specific Interaction ◽

Cost Effective ◽

Common Complication ◽

Total Hip ◽

Cost Effective Treatment ◽

Coexpression Networks

Total hip arthroplasty (THA) is a cost-effective treatment for osteoarthritis (OA), and osteolysis is a common complication of THA. This study was aimed at exploring the relevant molecular biomarkers for osteolysis after THA. We performed RNA sequence to identify and characterize expressed mRNAs and lncRNAs in OA and osteolysis. Differentially expressed mRNAs (DEmRNAs) and lncRNAs (DElncRNAs) in OA and osteolysis were acquired, as well as shared DEmRNAs/DElncRNAs in OA and osteolysis and osteolysis-specific DEmRNAs/DElncRNAs. Then, shared and osteolysis-specific DElncRNA-DEmRNA coexpression networks were constructed to further investigate the function of DElncRNAs and DEmRNAs in OA and osteolysis. In total, 343 DEmRNAs and 25 DElncRNAs in OA, 908 DEmRNAs and 107 DElncRNAs in osteolysis, and 406 DEmRNAs and 46 DElncRNAs between OA and osteolysis were acquired. A total of 136 shared DEmRNAs and 9 shared DElncRNAs in OA and osteolysis and 736 osteolysis-specific DEmRNAs and 103 osteolysis-specific DElncRNAs were acquired. Then, 128 shared DElncRNA-DEmRNA coexpression pairs and 522 osteolysis-specific DElncRNA-DEmRNA coexpression pairs were identified. The present study highlighted the roles of four interaction pairs, including two shared lncRNA-mRNA interaction pairs in OA and osteolysis (AC111000.4 and AC016831.6), which may function in the immune process of OA and osteolysis by regulating CD8A and CD8B, respectively, and two osteolysis-specific interaction pairs (AC090607.4-FOXO3 and TAL1-ABALON), which may play an important role in osteoclastogenesis.

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Minimum 10-Year Outcome of One-Stage Total Hip Arthroplasty Without Subtrochanteric Osteotomy Using a Cementless Custom Stem for Crowe III and IV Hip Dislocation

The Journal of Arthroplasty ◽

10.1016/j.arth.2018.02.055 ◽

2018 ◽

Vol 33 (7) ◽

pp. 2197-2202 ◽

Cited By ~ 11

Author(s):

Olivier Freddy Hitz ◽

Xavier Flecher ◽

Sébastien Parratte ◽

Matthieu Ollivier ◽

Jean-Noël Argenson

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Hip Dislocation ◽

Total Hip ◽

One Stage

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

10.1007/978-3-030-80695-8_3 ◽

2021 ◽

pp. 23-40

Author(s):

Ricardo Fernández-Fernández ◽

Ana Cruz-Pardos ◽

Eduardo García-Rey

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Two Stage ◽

Total Hip ◽

One Stage

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To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

SICOT-J ◽

10.1051/sicotj/2019032 ◽

2019 ◽

Vol 5 ◽

pp. 35

Author(s):

Frank Van Praet ◽

Michiel Mulier

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

English Literature ◽

Cost Effective ◽

Acetabular Cup ◽

Qualitative Synthesis ◽

Osteoarthritis Of The Hip ◽

Total Hip ◽

Primary Osteoarthritis ◽

Cemented Stem

Introduction: Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods: A comprehensive PubMed search of the English literature for studies published between 2007 and 2018 was performed. Studies comparing the clinical (revision rate, functionality), radiological (wear) or economic (cost) differences between cemented (cemented stem with cemented cup) and hybrid (cemented stem with uncemented cup) prostheses for primary osteoarthritis of the hip were identified as eligible. Results: A total of 1032 studies were identified whereof twelve were included for qualitative synthesis. All studies concerning the risk of revision were based on registry data, covering a total of 365,693 cups. Cemented prostheses had a similar or lower risk of revision compared to hybrid prostheses in every study, but performed slightly worse on functionality and quality of life. While cemented prostheses were the cheapest option, hybrids were the most cost-effective. Discussion: The widespread preference for cementless fixation of the acetabulum cannot be explained by a superior survival of cementless or hybrid models. Irrespective of age, cemented fixation of the acetabulum remains the gold standard to which other techniques should be compared.

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