BILATERAL TOTAL HIP-ARTHROPLASTY - ONE-STAGE VERSUS 2-STAGE PROCEDURE

The purpose of this study was to determine if any differences existed in the early complication fate, short term clinical outcome, and total length of hospital stay between patients who had bilateral total hip arthroplasty performed under a single anesthetic (during 1 patient vis it to the operating room) and patients who had the procedure performed under 2 anesthetics (during 2 patient visits to the operating room), Patients operated on bilaterally were divided into 3 groups: Group A ( 1 stage procedure)-hips that were operated on simultaneously (128 hips ); Group B (2 stage procedure)-surgeries performed less than 6 weeks a part (126 hips); and Group C (2 stage procedure)-surgeries performed b etween 5 weeks and 6 months apart (256 hips), All patients were evalua ted after an average followup of 1.5 years, There were no differences in operative, early local, or general complications among the 3 groups , In particular, no higher incidence of pulmonary embolism or deep vei n thrombosis was found in the 1 stage group, Preoperatively, very stif f hips (total range of motion < 50 degrees) gained significantly more motion in the 1 stage group than in the 2 stage groups, whereas hips w ith better preoperative motion (total range of motion > 50 degrees) im proved the most in Group B, without a significant difference occurring between Groups A and C. The degree of pain reduction was the same in all groups, but patients in the 1 stage group had a significantly bett er capacity for walking after their procedure, Average total hospital stay was 5 to 6 days less for the patients in Group A than those in th e other groups, which, combined with using the operating room only onc e, resulted in a reduction of overall hospital rests by more than 30% when using the 1 stage procedure.