Single stage bilateral total hip replacement: Is it an option or a risk?

Objective: To evaluate safety and feasibility of two-stage total hip arthroplasty and to compare it with single-stage procedure. Methods: The retrospective study was conducted at The Aga Khan University Hospital and comprised all cases of total hip replacements between January 2001 and December 2014 that were retrieved from the database using International Classification of Diseases (9th Revision) coding. A standardised questionnaire was completed, including patient demographics, primary diagnosis, peri and postoperative morbidity and mortality. Differences among patients' data were analysed using chi square test for dichotomous variables and student t-test for continuous variables. Results: Of the 48 cases, 34(71%) had single-stage bilateral total hip replacement and 14(29%) had two-stage procedure. Themean hospital stay in the single-stage group was 8.1 +/- 3.2 days compared to 19.6 +/- 5 days in the other group. The two-stage group required a significantly greater need for transfusion compared to the single-stage group (P< 0.05). There was no statistically significant increase in peri or postoperative complication (p> 0.05). Conclusion: Simultaneous bilateral total hip arthroplasty was found to be a safe and viable option with a decreased transfusion requirement and shorter hospital stay along with no significant increase in morbidity or mortality. Keywords: Total hip arthroplasty, Aga Khan University Hospital, International Classification of Diseases.