Clinical outcomes and cost analysis of one- versus two-stage bilateral hip arthroplasty. A retrospective study of a single surgeon experience

Purpose:One in 10 patients presenting for total hip arthroplasty (THA) will have significant osteoarthritis in both hips. In appropriately selected individuals, one-stage bilateral THA is a treatment option. This study aims to compare outcomes of one-stage bilateral THA with two-stage procedure. Methods:A retrospective review of a single surgeon series was conducted comparing One-stage bilateral THA (n = 59) with two-stage bilateral THA (n = 50). The primary outcomes were post-operative complication and the Oxford Hip Score. The secondary outcome was a financial analysis. Results:Complications were infrequent and comparable between both groups. Oxford hip scores were slightly higher in the one-stage group. One-staged bilateral THA had a lower cost but hospital tariff is higher for two-stage bilateral THA. Conclusion:In appropriately selected patients with bilateral hip arthritis, one-stage bilateral THA gives good clinical outcomes. However, the current payment system in the NHS makes two-stage bilateral THA more financially viable to the hospital.