The Symmetry and Predictive Factors in Two-Stage Bilateral Hip Replacement Procedures

Abstract

Background: Approximately 10–25% of total hip replacement patients undergo a bilateral procedure. The purpose of this study was to compare selected parameters associated with the first and second hip arthroplasty in patients undergoing two-stage treatment due to bilateral hip osteoarthritis and establish the predictive factors for the second procedure. Methods: This study compared the data on bilateral total hip replacement surgeries conducted in the period between 2017 and 2021 (42 patients). The following parameters from the first and second procedure were compared: the prosthetic stem, head, and insert cup size; type of cup insert; duration of anesthesia; duration of hospitalization; and the number of complications. Results: The mean duration of hospital stay at the time of the first total hip arthroplasty was 5.83 days and 5.4 days during the second stay. The mean stem sizes used during the first and second total hip replacement procedures were 7.11 and 7.09, respectively. The mean sizes of endoprosthetic cups used at the first and second total hip replacement procedures were 52.64 and 53.04, respectively. There were no significant differences between the mean prosthetic head size at the first and second surgery. The cup type used during the first and second surgery showed no difference. The mean duration of anesthesia used during the first and second total hip replacement surgery was 108.09 min and 104.52 min, respectively. We recorded a mean of 0.07 complications per patient at the first surgery and 0.02 at the second surgery. Conclusions: Our study results showed symmetry duration of anesthesia, length of hospital stay, number of complications per patient, stem size, prosthetic head size, cup insert size, and cup insert type at the first and second surgery in patients with two-stage bilateral total hip arthroplasty. We observed a strong correlation between the stem sizes of the first and second hip endoprostheses. There was also a strong correlation between the cup sizes used during the first and second surgery.

Prognostic Factors in Staged Bilateral Total Knee Arthroplasty—A Retrospective Case Series Analysis

“…Most of the evaluated patients had a dominant right lower limb, did physical labor, and were retired. It is possible that right lower limb dominance may have accelerated the development of degenerative chances in the right knee joint, in a similar way as that observed in the right hip joint [22]. However, the small sample size prevents us from drawing such conclusions and necessitates caution in data interpretation.…”

“…The staged approach to knee osteoarthritis treatment may be better than simultaneous bilateral knee arthroplasty due to the possibility of identifying prognostic factors for the second procedure [7,11,17,22]. It may be important to identify and predict the risk factors for the second surgery in patients undergoing bilateral TKR procedures.…”

“…However, most authors choose the staged approach, which reduces loss of blood, the rate of complications, the extent of the procedure, and the required rehabilitation period and enables the patient to more rapidly resume physical activity [8][9][10][11]16,17,20]. Another potential advantage of the staged approach over simultaneous TKR is the opportunity to determine the prognostic factors for the second procedure [7,11,17,22].…”

“…There have been no studies in which the data from the first TKR procedure were used to analyze the prognostic factors that could affect the subsequent procedure in the contralateral knee. A thorough understanding of the various factors involved in and resulting from single knee arthroplasty may considerably facilitate the course of the subsequent procedure in the other knee [7,11,22]. Knowing the parameters of the components already implanted during the first procedure (femoral component size, tibial component size, and tibial polyethylene insert size) may considerably facilitate the planning of the surgery for the other knee joint.…”

“…Knowing the parameters of the components already implanted during the first procedure (femoral component size, tibial component size, and tibial polyethylene insert size) may considerably facilitate the planning of the surgery for the other knee joint. This would also prepare the orthopedists for potential difficulties and complications, which would greatly improve the course of the procedure and the planning of rehabilitation [7,11,22].…”