Abstract
Introduction: Previous studies have suggested that bilateral total hip replacement (THR) is a safe and economically advantageous procedure. It has not become routine practice in many centres due to persisting concerns about complications and the patients’ ability to rehabilitate. In this study we compare one group of patients who underwent bilateral THR with another group who had only a unilateral procedure despite osteoarthritis in both hips. They were assessed for complications and functional outcome.
Methods: All data collected prospectively between 1998 and 2002. All patients had osteoarthritis and were recruited during the same time period . Group A comprised 49 patients who were listed for bilateral THR. Group B consisted of 215 patients listed for unilateral THR, with both hips symptomatic. Pain and function were assessed using the Harris Hip Score preoperatively and at 6 months post operatively. All intra and postoperative complications were recorded.
Results: There was no statistical difference between the groups for sex , pathology, body mass index or American Society of Anaesthetists (ASA) scores.
There is a difference in age between the two groups with the bilateral group being younger (p< 0.01).
Although group A had a higher death rate, it was not statistically significant. The deep infection and revision rate was similar for both groups. The average length of stay for group A was 13 days compared to 8 days for group B.There was a significant difference in the likelihood of blood transfusion with a transfusion rate of 78% in group A and 22% in group B (p< 0.001).
Conclusion: This study has demonstrated no significant increased risk of death, deep infection or need for revision with bilateral hip replacements. The increased likelihood of blood transfusion should be offset against the definite economic advantages and the good early outcome from performing bilateral total hip replacements.
The abstracts were prepared by Mr Peter Kay, Editorial Secretary. Correspondence should be addressed to British Hip Society, The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
