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Perioperative Morbidity of Same-Day and Staged Bilateral Total Hip Arthroplasty
Authors:Lazaros A Poultsides  Georgios K Triantafyllopoulos  Stavros G Memtsoudis  Huong T Do  Michael M Alexiades  Thomas P Sculco
Institution:1. Division of Adult Reconstruction and Joint Replacement, Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York;2. Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York;3. Epidemiology and Biostatistics Core, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York
Abstract:

Background

Management strategies for bilateral hip degenerative disease include same-day or staged bilateral total hip arthroplasty (THA), but information on outcomes remains sparse. We sought to describe in-hospital complications and blood transfusion rates after same-day and staged bilateral THAs at different time intervals and to assess risk factors for these events.

Methods

We retrospectively reviewed administrative data for 3785 patients treated with same-day bilateral (n = 1946; group A) and staged bilateral THA within (1) 0-3 months apart (n = 328; group B); (2) 3-6 months apart (n = 703; group C); and (3) 6-12 months apart (n = 808; group D), between 1999 and 2014. We recorded demographics, the Charlson-Deyo comorbidity index and in-hospital local and systemic (minor and major) complications. Complication and blood transfusion rates among groups were compared. A logistic regression model was developed to identify risk factors for major complications.

Results

Local complications were rare. Minor complications were less frequent in group A (P < .001). Major complications were more frequent in group D (P = .012). Group A had higher overall (P < .001) and allogeneic blood transfusion rates (P < .001) compared with the staged groups. Staged procedures within 6-12 months apart vs same-day bilateral THA, older age, Charlson-Deyo index ≥2 vs 0, and earlier vs recent admission year were associated with higher adjusted odds for major complications.

Conclusion

Same-day bilateral THA in a high-volume joint replacement center may be a safe option for younger and healthier patients, given the relatively low incidence of adverse events reported in this study.
Keywords:total hip arthroplasty  bilateral  same-day  staged  complications
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