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Cheng R, Mantena Y, Chiu YF, Kahlenberg CA, Figgie MP, Driscoll DA. To Stage or Not to Stage? Comparison of Patient-Reported Outcomes, Complications, and Discharge Disposition After Staged and Simultaneous Bilateral Posterior Total Hip Arthroplasty. J Arthroplasty 2024; 39:1752-1757. [PMID: 38216001 DOI: 10.1016/j.arth.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 12/23/2023] [Accepted: 01/07/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Patients who have bilateral hip arthritis can be treated with bilateral total hip arthroplasty (bTHA) in either a staged or simultaneous fashion. The goal of this study was to determine whether staged and simultaneous posterior bTHA patients differ in regard to (1) patient-reported outcome measures, (2) 90-day complication rates, and (3) discharge dispositions and cumulative lengths of stay. METHODS Patients who (1) underwent simultaneous bTHA or staged bTHA (within 12 months) using the posterior approach, and (2) completed preoperative and 1-year postoperative Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement surveys were included in the study. A total of 266 patients (87 simultaneous bTHA and 179 staged bTHA) were included. Chart review was performed to collect patient-level variables, postoperative complications, discharge dispositions, and lengths of stay. RESULTS Staged bTHA patients had higher Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement, Lower Extremity Activity Scale, and Veterans RAND 12-Item Health Survey physical component scores compared to simultaneous bTHA patients at 6 weeks after surgery (P = .019, .006, and .008, respectively), but these differences did not meet the minimal clinically important difference threshold for any questionnaire. Simultaneous bTHA was associated with higher rate of periprosthetic fractures (P = .034) and discharge to a location other than home (P < .001). CONCLUSIONS There were statistically significant, but likely not clinically meaningful differences in patient-reported outcomes for staged and simultaneous bTHA patients at 6 weeks after surgery. Surgeons should be aware of the higher periprosthetic fracture risk and greater likelihood of discharge to a rehabilitation facility associated with simultaneous bTHA. Further research should aim to understand which patients may benefit most from simultaneous bTHA.
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Affiliation(s)
- Ryan Cheng
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York
| | - Yasoda Mantena
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York
| | - Yu-Fen Chiu
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York
| | - Cynthia A Kahlenberg
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York
| | - Mark P Figgie
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York
| | - Daniel A Driscoll
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York
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Doyle TR, Davey MS, Toale JP, O'Driscoll C, Murphy CG. Simultaneous bilateral total hip arthroplasty-a survey of Irish orthopaedic surgeons' practice. Ir J Med Sci 2024:10.1007/s11845-024-03726-1. [PMID: 38837013 DOI: 10.1007/s11845-024-03726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 05/24/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Bilateral total hip arthroplasty may be performed simultaneously (SIMTHA) or in two staged operations. AIM To assess attitudes towards and utilization of SIMTHA in Irish orthopaedic practice, and to assess patient and surgeon factors which are associated with the management of bilateral hip arthritis. METHODS A 16-question electronic survey (Google Forms) was distributed via email to consultant Irish orthopaedic surgeons who perform total hip arthroplasty, followed by a reminder 1 month later. A p value < 0.05 was considered significant. RESULTS There were 53 responses from arthroplasty surgeons, with 28% reporting they never perform SIMTHA, 26% have performed ≤ 5 SIMTHA, and 46% do ≥ 1 SIMTHA per year. Amongst the 15 surgeons who do not do SIMTHA, 60% reported a preference for staged arthroplasty, 20% felt it was not feasible in their institution, and a third reported a lack of experience with SIMTHA. There was a significant association between not performing SIMTHA and years of consultant experience (p = 0.002). There were no institutional guidelines on eligibility criteria for SIMTHA. The most common time interval for staged bilateral arthroplasty was 6-12 weeks (60%). Overall, 56% of surgeons felt SIMTHA is underutilised in the Irish healthcare system; this was associated with greater SIMTHA volume (p = 0.023). CONCLUSION Half of the Irish arthroplasty surgeons report SIMTHA is a regular aspect of their practice. Performing SIMTHA is associated with greater arthroplasty volume, more recent consultant appointments, and a perception that the operation is underutilised.
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Affiliation(s)
- Tom R Doyle
- Department of Orthopaedics, Galway University Hospital, Galway, Ireland.
- Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Martin S Davey
- Department of Orthopaedics, Galway University Hospital, Galway, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James P Toale
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Conor O'Driscoll
- Department of Orthopaedics, Galway University Hospital, Galway, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Colin G Murphy
- Department of Orthopaedics, Galway University Hospital, Galway, Ireland
- Royal College of Surgeons in Ireland, Dublin, Ireland
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Maggini E, Scheibel M. Simultaneous bilateral total shoulder arthroplasty with contralateral autograft transfer for glenoid deficiency. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:241-247. [PMID: 38706687 PMCID: PMC11065735 DOI: 10.1016/j.xrrt.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- Emanuele Maggini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
| | - Markus Scheibel
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
- Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Berlin, Germany
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Rajahraman V, Ashkenazi I, Thomas J, Bosco J, Davidovitch R, Schwarzkopf R. Simultaneous Versus Staged Bilateral Total Hip Arthroplasty: A Matched Cohort Analysis of Revenue and Contribution Margin. J Arthroplasty 2024:S0883-5403(24)00413-3. [PMID: 38677345 DOI: 10.1016/j.arth.2024.04.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Though previous studies have demonstrated improved cost benefits associated with simultaneous versus staged bilateral total hip arthroplasty (simBTHA and staBTHA), further investigation is needed regarding the revenues and contribution margins (CMs) of these procedures. In this study, we compared revenue, CM, and surgical outcomes between simBTHA and staBTHA. METHODS All patients who underwent simBTHA (both procedures completed the same day) and staBTHA (procedures completed on different days within one year) between 2011 and 2021 at a single high-volume orthopedic specialty hospital were identified. Of the 1,517 identified patients (n = 139 simBTHA, n = 1,378 staBTHA), 232 were included in a 1:1 propensity match based on baseline demographics (116 per cohort). Revenue, costs, CM, and surgical outcomes were compared between cohorts. RESULTS Compared to staBTHA, simBTHA procedures had significantly lower total costs (P < .001), direct costs (P < .001), and patient revenue. There was no significant difference in CM between groups (P = .361). Additionally, there were no significant differences in length of stay (P = .173), operative time (P = .438), 90-day readmissions (P = .701), 90-day revisions (P = .313), or all-cause revisions (P = .701) between cohorts. CONCLUSIONS Though simBTHA procedures have lower revenues than staBTHA, they also have lower costs, resulting in similar CM between procedures. As both procedures have similar postoperative complication rates, further research is required to evaluate specifically which patients may benefit from simBTHA versus staBTHA regarding clinical and patient-reported outcomes. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Vinaya Rajahraman
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Itay Ashkenazi
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York; Division of Orthopaedic Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Jeremiah Thomas
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Joseph Bosco
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Roy Davidovitch
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York
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Fletcher AN. Bilateral Total Ankle Arthroplasty. Foot Ankle Clin 2024; 29:97-109. [PMID: 38309806 DOI: 10.1016/j.fcl.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2024]
Abstract
Patients with bilateral ankle arthritis have higher rates of primary and secondary/inflammatory arthritis and a more debilitating condition than those with unilateral pathology. The limited bilateral total ankle arthroplasty (TAA) literature supports both 1-surgeon and 2-surgeon team bilateral TAAs as safe and effective with comparable improvements in patient-reported outcome measures (PROMs), complications, reoperations, and prosthesis survival as unilateral TAA and staged bilateral TAA. Additional benefits of bilateral arthroplasty supported in the hip and knee literature include cost reduction, noninferior and even superior perioperative complication profiles, improved PROM and satisfaction, shorter recovery time, early rehabilitation, and less time away from employment.
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Tripathy SK, Jain M, Varghese P, Jena S. Concurrent replacement of four major joints in a woman with advanced rheumatoid arthritis. BMJ Case Rep 2024; 17:e258214. [PMID: 38320823 PMCID: PMC10859981 DOI: 10.1136/bcr-2023-258214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
We report a case of a woman in her mid-40s with advanced rheumatoid arthritis (RA), with bilateral hip and knee joint involvement, who underwent a one-stage quadruple joint arthroplasty during a single session of anaesthesia. Chronic RA had severely incapacitated her, necessitating this uncommon surgical intervention. The surgical approach involved sequential bilateral total hip and knee replacements, which were completed within 180 min with a cumulative blood loss of 950 mL. The patient showed significant improvement with rapid mobilisation and regained joint function postoperatively. At 8 months post-surgery, the patient resumed her daily activities, showcasing the potential benefits and positive outcomes of quadruple joint arthroplasty in selected RA patients. This case, only the second documented globally, highlights the complexities and possibilities surrounding a single-stage quadruple joint arthroplasty in advanced RA.
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Affiliation(s)
| | - Mantu Jain
- Orthopedics, AIIMS Bhubaneswar, Bhubaneswar, Orissa, India
| | | | - Sritam Jena
- Anaesthesia, AIIMS Bhubaneswar, Bhubaneswar, Orissa, India
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Yakkanti RR, Syros A, Reddy GB, D’Apuzzo MR. In-Hospital Complications and Costs of Simultaneous Bilateral Total Hip Arthroplasty: The Case for Selection and Potential Cost Savings. Arthroplast Today 2024; 25:101294. [PMID: 38313189 PMCID: PMC10834459 DOI: 10.1016/j.artd.2023.101294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/19/2023] [Accepted: 11/03/2023] [Indexed: 02/06/2024] Open
Abstract
Background Published comparisons between bilateral and unilateral total hip arthroplasty (THA) remain controversial regarding the potential risks and benefits. Our objectives were to compare (1) postoperative complications and (2) resource utilization of patients having simultaneous bilateral THA with patients having unilateral procedures. Methods The Nationwide Inpatient Sample was used to identify patients undergoing primary elective THA from January 2016 to December 2019. Complications and costs were compared between unilateral and simultaneous bilateral patients. Binary logistic regression analysis controlling demographics, comorbidities, and the primary diagnosis was performed to compare the cohorts of unilateral and bilateral patients. Results Nine thousand nine hundred fifty-five Bilateral procedures and 785,609 unilateral procedures were identified. Patients with bilateral procedures were at increased risk for many medical complications including gastrointestinal complications (OR: 4.1; 95% CI: 2.4-6.9, P < .01), postoperative blood transfusions (OR: 3.6; 95% CI: 3.3-3.9, P < .01), and pulmonary embolisms (OR: 3.2; 95% CI: 2.0-5.1, P < .01). Patients with bilateral procedures were also at increased risk for joint complications, including periprosthetic fractures (OR: 7.4; 95% CI: 5.2-10.5, P < .01) and other mechanical complications (OR: 27.0; 95% CI: 23-30, P < .01). These patients also incurred higher index hospitalization costs ($25,347 vs $16,757, P < .001) and were discharged more commonly to a rehabilitation facility (17.8% vs 13.4%, P < .001). Conclusions Bilateral THA are at increased risk of developing postoperative complications despite being younger and having fewer comorbidities on average when compared with unilateral patients. While bilateral patients had a higher index hospitalization cost, the overall cost of one episode of care is lower than two separate hospitalizations.
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Affiliation(s)
- Ramakanth R. Yakkanti
- Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alina Syros
- Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Gireesh B. Reddy
- Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michele R. D’Apuzzo
- Department of Orthopaedics and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
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Kirschbaum S, Hube R, Perka C, Ley C, Rosaria S, Najfeld M. Bilateral simultaneous hip arthroplasty shows comparable early outcome and complication rate as staged bilateral hip arthroplasty for patients scored ASA 1-3 if performed by a high-volume surgeon. INTERNATIONAL ORTHOPAEDICS 2023; 47:2571-2578. [PMID: 37355529 PMCID: PMC10522735 DOI: 10.1007/s00264-023-05871-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE The aim of this study was to compare early outcomes after simultaneous and staged hip arthroplasty (THA) in patients with bilateral symptomatic pathology. METHODS We conducted a retrospective cohort study including all patients scheduled for primary THA for bilateral hip osteoarthritis (OA, n = 290). Patients either received simultaneous (n = 152, 52.4%) or staged (n = 138, 47.6%) bilateral THA based on individual preference. All operations (n = 428) were performed by one single, high-volume surgeon. Demographic data (e.g., age, ASA score) as well as perioperative parameters (haemoglobin drop (Hb), red blood cell transfusion, length of stay (LOS), operation time, six week complication rate and achievement of inpatient rehabilitation key points) were evaluated. RESULTS Patients in the simultaneous bilateral THA group were younger (62.8 ± 8.9 vs. 65 ± 9.7 years, p = 0.022) and had lower ASA scores (1.8, (34.2% ASA 1, 55.3% ASA 2, 37.2% ASA 3) vs. 2.0 (18.8% ASA 1, 61.6% ASA 2, 19.6% ASA 3)) than the staged group. While the average LOS was 7.1 ± 1.7 days for simultaneous bilateral THA, the combined LOS for the staged group was 12.9 ± 2.4 days (p < 0.001). The cumulative operation time in the simultaneous bilateral THA group was 61.1 ± 11.5 min and 57.6 ± 7.3 min in the staged group (p < 0.015). Cumulative Hb loss was significantly higher in the staged group (2.1 ± 7.2 g/dl vs. 3.7 ± 1.3 g/dl, p < 0.001). No significant differences were found concerning the complication rate or early inpatient rehabilitation. CONCLUSION Simultaneous bilateral hip arthroplasty in patients with symptomatic bilateral hip osteoarthritis is as safe and successful as a staged procedure if performed by a high-volume surgeon.
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Affiliation(s)
- Stephanie Kirschbaum
- Centre for Musculoskeletal Surgery, Charité-University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Robert Hube
- OCM Orthopädische Chirurgie München, Steinerstraße 6, 81369, Munich, Germany
| | - Carsten Perka
- Centre for Musculoskeletal Surgery, Charité-University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Christophe Ley
- University of Luxembourg, 2 Av. de l'Universite, 4365, Esch-sur-Alzette, Luxembourg
| | - Simone Rosaria
- University of Napoli Federico II, Corso Umberto I 40, 80138, Naples, Italy
| | - Michael Najfeld
- OCM Orthopädische Chirurgie München, Steinerstraße 6, 81369, Munich, Germany
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Bindumadhavan S, Sharma A, Killampalli V. Functional and Radiological Outcomes Following Simultaneous Bilateral Total Hip Arthroplasty: Analysis of a Retrospective Series. Cureus 2023; 15:e46361. [PMID: 37920626 PMCID: PMC10619522 DOI: 10.7759/cureus.46361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
Introduction The prevalence of bilateral hip arthritis continues to rise. With the dramatic change in the practice of modern-day arthroplasty with standard operating protocols and guidelines in place to reduce the incidence of surgical site infection and peri-operative thromboembolic events, simultaneous bilateral total hip replacement (THR) has been considered a viable option to reduce morbidity. The efficacy of simultaneous bilateral THR with regard to patient outcomes and complications has been debated. The aim of this study was to assess and compare the functional outcomes, radiological outcomes, and complications following bilateral simultaneous THR with the existing literature. Methods We conducted a retrospective study of 28 patients who underwent simultaneous bilateral THR by a single surgeon at a district general hospital in the United Kingdom between 2010 and 2019. All the patients in the study were operated on via the posterior approach to the hip and received uncemented implants. Data on blood loss and hospital stay were collected from the hospital records. The radiological outcomes were studied from the post-operative radiographs. The patient-reported outcomes were measured via a telephone session at an average follow-up of 7.8 years. Results Our results noted a statistically significant drop in haemoglobin after the procedure from a mean of 13.5 g/dl to 9.05 g/dl (t: -15.84, p < 0.00001). The average blood loss was 643 ml +/- 330 ml (200-1850 ml). Nine patients (32.1%) required blood transfusions and a total of 21 units were transfused. The mean duration of stay in the hospital was 6.7 days (three to 20 days). There were no intra-operative/immediate/early post-operative complications. The revision rate was 1.7%, as one patient had a revision of the femoral component following a peri-prosthetic fracture. The mean visual analogue scale pain score was 1.51 +/- 0.58 (1-3). The mean Oxford Hip Score improved from 19.5 (12-28) pre-operatively to 44.3 (37-48) post-operatively at the time of the study (t: -21.88945; p < 0.00001), with the difference being statistically significant using a paired t-test. From the series, 14 (50%) patients were found to have limb length discrepancies. The mean limb length discrepancy was found to be 2.3 mm (0-16 mm). In 13 of the 28 patients (46.4%), the global hip offset was equal on both sides. In two patients, the difference in the global hip offset was more than 10 mm. Conclusion We reported good patient-reported functional outcomes with simultaneous bilateral THR with a low complication rate. Despite the lack of opportunity to template the second hip, the limb length and global hip offset can be restored after a simultaneous bilateral THR.
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Affiliation(s)
| | - Anirudh Sharma
- Trauma and Orthopaedics, Worcestershire Royal Hospital, Worcester, GBR
| | - Vijay Killampalli
- Trauma and Orthopaedics, North West Anglia NHS Foundation Trust, Huntingdon, GBR
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Moharrami A, Mirghaderi P, Moazen-Jamshidi MM, Hoseini Zare N, Sharifpour S, Mortazavi SMJ. Bilateral total hip arthroplasty in a case with fibrous dysplasia: a case report. J Med Case Rep 2023; 17:371. [PMID: 37644615 PMCID: PMC10466812 DOI: 10.1186/s13256-023-04084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 07/16/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Fibrous dysplasia (FD) is a benign neoplasm with a broad spectrum of presentations. The treatment of FD in the hip region is controversial among orthopedic surgeons. Several treatment options exist, including curettage and grafting, valgus osteotomy, medial displacement osteotomy, and so on. Performing total hip arthroplasty (THA) on these patients and their subsequent outcome is still in infancy. CASE PRESENTATION The patient is a 32-year-old white female with bilateral proximal femur FD who underwent bilateral THA with long stem implants. A year following surgery, she had no complications and had satisfactory radiological, pain, and functional outcomes. CONCLUSION A bilateral THA with a long stem prosthesis showed promising results when performed following appropriate curettage of the proximal bone in an FD case. A cementless long stem could have enabled better diaphyseal fixation distal to the lesion site.
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Affiliation(s)
- Alireza Moharrami
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, Iran
| | - Peyman Mirghaderi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, Iran
- Surgical Research Society (SRS), Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Mansour Moazen-Jamshidi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, Iran
| | - Nima Hoseini Zare
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, Iran
| | - Sadula Sharifpour
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, Iran
| | - S M Javad Mortazavi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, End of Keshavarz Blvd, Tehran, Iran.
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BIAZZO A, ZANCHINI F, SARACCO M, RICCIARDELLO S, SARACCO A, POLA E, VERDE F. One-staged hip and knee arthroplasty: a retrospective clinical and radiographical study. MINERVA ORTHOPEDICS 2023; 74. [DOI: 10.23736/s2784-8469.23.04220-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2023]
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Reinbacher P, Hecker A, Friesenbichler J, Smolle M, Leitner L, Klim S, Draschl A, Colovic D, Brunnader K, Leithner A, Maurer-Ertl W. Simultaneous Bilateral Total Hip Arthroplasty with Straight-Stems and Short-Stems: Does the Short One Do a Better Job? J Clin Med 2023; 12:1028. [PMID: 36769676 PMCID: PMC9918178 DOI: 10.3390/jcm12031028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) is known to be the most successful orthopaedic surgery of the last century, but it is still struggling with controversies concerning one-stage bilateral THA. The current study aimed to compare the clinical outcome of patients with unilateral or simultaneous bilateral THA by using short-stem and straight-stem designs and focusing on operation time, blood loss, and length of hospital stay (LOS). MATERIAL AND METHODS Between 2006 and 2018, 92 patients were enrolled in this study. Forty-six patients underwent a bilateral THA in one session, and forty-six matched patients underwent a unilateral THA. In each of the two groups (unilateral vs. bilateral), 23 patients received either a straight (unilateral: 10 females, 13 males, mean age 63; bilateral: 12 females, 11 males, mean age 53 years) or short stem (unilateral: 11 females, 12 males, mean age 60 years; bilateral: 12 females, 11 males, 53 mean age 62 years). The blood count was checked preoperatively as well as one and three days after surgery. Furthermore, the operation time and LOS were investigated. RESULTS Compared to THA with straight-stems, short-stem THA showed significantly less blood loss; there was no difference in the LOS of both groups. A significantly shorter operative time was only observed in the bilateral THA. CONCLUSION The current study showed that simultaneous bilateral THA appears to be safe and reliable in patients without multiple comorbidities. In addition, short-stem THA appears to be beneficial in terms of clinical performance and outcome, and it appears to be superior to straight-stem THA, regardless of whether the patient underwent unilateral or simultaneous bilateral THA.
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Affiliation(s)
- Patrick Reinbacher
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Andrzej Hecker
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Joerg Friesenbichler
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Maria Smolle
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Lukas Leitner
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Sebastian Klim
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Alexander Draschl
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Danijel Colovic
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Kevin Brunnader
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Andreas Leithner
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
| | - Werner Maurer-Ertl
- Department of Orthopaedics & Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria
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Chang X, Feng J. Comment on the article by Wang et al.: Enhanced recovery after surgery for primary total hip arthroplasty: analysis of post‑operative blood indexes. INTERNATIONAL ORTHOPAEDICS 2023; 47:95-96. [PMID: 36334138 DOI: 10.1007/s00264-022-05627-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Xinjie Chang
- The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, No.24 Jinghua Road, Luoyang, 471003, Henan Province, China.
| | - Jueli Feng
- The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, No.24 Jinghua Road, Luoyang, 471003, Henan Province, China
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