Functional and Radiological Outcomes of Single-Stage Bilateral Total Hip Replacement: A Retrospective Observational Study.

Abstract

One-stage bilateral total hip replacement (THR) offers numerous benefits including reduced anesthetic exposure, single hospital admission, shorter hospital stay, quicker rehabilitation, and lower expenses. We conducted a retrospective study to evaluate the functional and radiological outcomes following this procedure. Our observational retrospective study included 30 patients undergoing one-stage bilateral THR via posterior approach by a single specialist surgeon. Data on ASA grade, hospital stay, preoperative and postoperative hemoglobin levels, and complications were collected from hospital records. The radiological outcomes were evaluated from the postoperative radiographs. Functional outcomes were assessed using modified Harris Hip Score, SF-36 score for quality-of-life, and the Self-Administered Patient Satisfaction Scale for Primary Hip and Knee Arthroplasty. In our cohort, 83% were ASA 1, 70% were male, with mean age was 45.1 years. Mean surgical duration was 175 min, with mean intra-operative blood loss was 834 ml. Mean length of stay was 9.9 days. Pre-operative hemoglobin averaged 12.45 g/dl, dropping by 2.15 g/dl postoperatively. No major complications were observed. Radiologically, mean values for Hip Offset, leg length, acetabular anteversion and inclination were within acceptable ranges. Statistically significant improvements were observed in Modified HHS (preoperative: 31.0 ± 16.2, postoperative: 86.7 ± 7.2). Patient satisfaction was high, with 86.66% reporting being very satisfied with surgery outcome. Our study suggests that single anesthesia bilateral THR in ASA 1 and 2 patients is associated with low complication rate and good functional outcomes. One-stage bilateral THR remains a safe option for patients with bilateral hip disease, provided appropriate patient selection and skilled surgical expertise are ensured.