RESUMO
Total hip arthroplasty is a successful procedure with high rates of functional satisfaction and pain relief. A large number of patients with bilateral hip pathology will require both hip joint replacement, from there born the inquietude to knowing benefits and disadvantage of bilateral simultaneous hip arthroplasty. We present a female patient case who developed bilateral hip osteoarthritis secondary to development dysplasia of the hip which was surgically managed with bilateral arthroplasty at one time. We show a follow-up report of the case and a review of the literature to know the main advantages of this new current of hip arthroplasty in patients with bilateral hip pathology
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Osteoartrite do Quadril/cirurgia , Artroplastia de Quadril/métodos , Radiografia , Osteoartrite do Quadril/complicações , Osteoartrite do Quadril/terapiaRESUMO
Purpose: We examined and compared the daily step counts and health-related quality of life of patients before undergoing either bilateral or unilateral (with or without arthritis in the opposite joint) total hip arthroplasty (THA), and for 6 months afterwards.Participants and Methods: Participants were patients who were living at home and were requested to wear accelerometers and log their daily step count preoperatively and again 6 months postoperatively. Additionally, they completed the Oxford Hip Score and EuroQol 5-Dimension questionnaires at both time points.Results: Data from 40 patients were analyzed. Patients underwent bilateral total hip arthroplasty (n=13), unilateral total hip arthroplasty with arthritis in the opposite joint (n=13), and unilateral total hip arthroplasty without arthritis in the opposite joint (n=14). The Oxford Hip Score and EuroQol 5-Dimension score showed that the daily step counts of patients who underwent bilateral or unilateral total hip arthroplasty without arthritis in the opposite joint significantly increased postoperatively, but that of patients who received unilateral THA with arthritis in the opposite joint did not change significantly. The Oxford Hip Score indicated an improvement in hip joint function after surgery, but the EuroQol 5-Dimension score did not show a significant change postoperatively in patients who received bilateral total hip arthroplasty.Conclusion: The pre- and postoperative comparisons of the participant’s daily step count after bilateral and unilateral operations without arthritis on the other side showed improvements in their amount of daily life activities. In all surgeries, Oxford Hip Score improvements were confirmed. The EuroQol 5-Dimension score of bilateral operations did not change. Bilateral operations and an understanding of unilateral postoperative qualitative support will be necessary in the future.
RESUMO
PURPOSE: To compare the postoperative complications and cost-effectiveness of simultaneous and staged bilateral total hip arthroplasty (THA), using a minimally invasive two-incision technique. MATERIALS AND METHODS: All 206 patients who underwent simultaneous or staged bilateral THA using a modified, minimally invasive two-incision between January 2004 and November 2009 were registered and divided into a simultaneous bilateral THA group (group A, 147 patients) and staged bilateral THA group (group B: 59 patients). Staged THA was performed on group B with interval of at least 2 months between the initial and second surgery. Clinical evaluations, amount of blood loss, need for transfusion, complications and costeffectiveness were compared. RESULTS: Perioperative morbidity rates were similar in the two groups (P=0.546) and overall complications were not significant between the groups. Average length of hospital stay was significantly shorter in group A than in group B (average 14.6 days vs. 25.3 days; P<0.001). Total medical cost was significantly higher in group B than in group A (average 9,236 US dollars vs. 11,163 US dollars). Patients in group A required more blood transfusions than those in group B (3.02 vs. 1.90 units; P=0.003), although blood loss in the two groups were similar (892 vs. 917 ml P=0.613). CONCLUSION: Comparison of intra- and postoperative complications support the conclusion that simultaneous bilateral THA compares favorably with staged THA in terms of outcomes, complications and cost-effectiveness.
Assuntos
Humanos , Artroplastia de Quadril , Transfusão de Sangue , Tempo de Internação , Métodos , Complicações Pós-OperatóriasRESUMO
We report on the medium term outcome of five patients (ten hips) who underwent one stage bilateral total hip arthroplasty. Both Harris Hip Scores and Oxford Hip Scores improved postoperatively as did range of motion. There was no radiographic evidence of loosening in any hip arthroplasty involved in this study, however one revision surgery was needed due to periprosthetic fracture. There were no increased medical complications. Based on our limited experience, we believe that one stage bilateral total hip