Abstract
Background
Simultaneous bilateral total hip arthroplasty (THA) can offer a potential benefit of greater postoperative hip motion without the negative influence of contralateral hip disabilities, compared to two-stage THA. However, postoperative changes in hip motion after simultaneous bilateral THA have rarely been reported. The purpose of this study was to clarify the efficacy of simultaneous procedures on postoperative hip motion and functional recovery.
Methods
We retrospectively compared hip motion in 27 patients treated with simultaneous bilateral THA to those in 11 patients with two-stage bilateral THA, 35 patients with unilateral THA for unilateral disease, and 15 patients with unilateral THA for bilateral disease. We also evaluated the clinical manifestations according to the Japanese Orthopaedic Association (JOA) hip scores and compared the outcomes among the groups. All of the THA surgeries were primarily performed through a posterolateral approach using cement-less prostheses. The diagnosis at surgery was dysplastic osteoarthritis in all patients, and the patients were followed up for at least 4 years.
Results
The postoperative improvement of motion in hip flexion was significantly greater in patients treated with simultaneous procedures compared to patients with two-stage THA and unilateral THA for bilateral disease. The differences in improvement of motion in hip abduction were less marked than the improvement in hip flexion among the groups. Although there were no significant differences in pain scores among the groups, the values for activity of daily living were significantly greater in patients treated with simultaneous bilateral THA and patients with unilateral THA for unilateral disease than in patients with unilateral and two-stage bilateral THA for bilateral disease.
Conclusions
The simultaneous procedure was considered to be more effective in patients with bilateral hip osteoarthritis and demonstrated a substantial improvement in hip motion and functional recovery after THA.
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References
Lazansky MG. A method for grading hips. J Bone Joint Surg Br 1967;49:644–651.
Ritter MA, Stringer EA. Bilateral total hip arthroplasty: a single procedure. Clin Orthop 1980;149:185–190.
Bracy D, Wroblewski BM. Bilateral Charnley arthroplasty as a single procedure. J Bone Joint Surg Br 1981;63:354–356.
Berend ME, Ritter MA, Harty LD, Davis KE, Keating EM, Meding JB, et al. Simultaneous bilateral versus unilateral total hip arthroplasty: an outcomes analysis. J Arthroplasty 2005;20:421–426.
Parvizi J, Pour AE, Peak EL, Sharkey PF, Hozack WJ, Rothman RH. One-stage bilateral total hip arthroplasty compared with unilateral total hip arthroplasty: a prospective study. J Arthroplasty 2006;21:26–31.
Eggli S, Huckell CB, Ganz R. Bilateral total hip arthroplasty: one stage versus two stage procedure. Clin Orthop 1996;328:108–118.
Alfaro-Adrián J, Bayona F, Rech JA, Murray DW. One- or two-stage bilateral total hip replacement. J Arthroplasty 1999;14:439–445.
Parvizi J, Tarity TD, Sheikh E, Sharkey PF, Hozack WJ, Rothman RH. Bilateral total hip arthroplasty: one-stage versus two-stage procedures. Clin Orthop 2006;453:137–141.
Bhan S, Pankaj A, Malhotra R. One- or two-stage bilateral total hip arthroplasty: a prospective, randomised, controlled study in an Asian population. J Bone Joint Surg Br 2006;88:298–303.
Reuben JD, Meyers SJ, Cox DD, Elliott M, Watson M, Shim SD. Cost comparison between bilateral simultaneous, staged, and unilateral total joint arthroplasty. J Arthroplasty 1998;13:172–179.
Tarity TD, Herz AL, Parvizi J, Rothman RH. Ninety-day mortality after hip arthroplasty: a comparison between unilateral and simultaneous bilateral procedures. J Arthroplasty 2006;21:60–64.
Lorenze M, Huo MH, Zatorski LE, Keggi KJ. A comparison of the cost effectiveness of one-stage versus two-stage bilateral total hip replacement. Orthopedics 1998;21:1249–1252.
Johnston RC, Smidt GL. Hip motion measurements for selected activities of daily living. Clin Orthop 1970;72:205–215.
Yoshii T, Jinno T, Koga D, Morita S, Muneta T, Shinomiya K. Range of motion after simultaneous bilateral total hip arthroplasty. Zasshi Seikeigeka 2006;57:1681–1686 (In Japanese).
Crowe JF, Mani VJ, Ranawat CS. Total hip replacement in congenital dislocation and dysplasia of the hip. J Bone Joint Surg Am 1979;61:15–23.
Yasunaga Y, Ochi M, Terayama H, Tanaka R, Yamasaki T, Ishii Y. Rotational acetabular osteotomy for advanced osteoarthritis secondary to dysplasia of the hip. J Bone Joint Surg Am 2006;88:1915–1919.
Mibe J, Imakiire A, Watanabe T, Fujie T. Results of total hip arthroplasty with bone graft and support ring for protrusio acetabuli in rheumatoid arthritis. J Orthop Sci 2005;10:8–14.
Woolson ST, Maloney WJ, Schurman DJ. Time-related improvement in the range of motion of the hip after total replacement. J Bone Joint Surg Am 1985;67:1251–1254.
Wykman A, Olsson E. Walking ability after total hip replacement: a comparison of gait analysis in unilateral and bilateral cases. J Bone Joint Surg Br 1992;74:53–56.
Offierski CM, MacNab I. Hip-spine syndrome. Spine 1983:8:316–321.
Hoaglund FT, Shiba R, Newberg AH, Leung KY. Diseases of the hip: a comparative study of Japanese oriental and American white patients. J Bone Joint Surg Am 1985;67:1376–1383.
Jewett BA, Collis DK. Sequential bilateral total hip replacement during the same hospitalization. Clin Orthop 2005;441:256–261.
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Yoshii, T., Jinno, T., Morita, S. et al. Postoperative hip motion and functional recovery after simultaneous bilateral total hip arthroplasty for bilateral osteoarthritis. J Orthop Sci 14, 161–166 (2009). https://doi.org/10.1007/s00776-008-1303-x
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DOI: https://doi.org/10.1007/s00776-008-1303-x