Harbison Gregory J, Andrews Samantha N, Nakasone Cass K
John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (GJH).
Department of Orthopedics, Straub Clinic & Hospital, Honolulu, HI (CKN, SNA).
Hawaii J Health Soc Welf. 2020 Mar 1;79(3):71-74.
Total hip arthroplasty (THA) is a commonly performed surgery, with candidates often requiring bilateral replacement. Simultaneous, single-stage bilateral THA offers several advantages and the direct anterior approach (DAA) for THA is well-suited for this procedure. In Hawai'i, single-stage bilateral DAA THA has yet to be adopted as a primary practice, and currently, there is limited research on patient outcomes following single-stage bilateral DAA THA in heterogeneous patient populations. In this study, we present our experience regarding intraoperative and 90-day complication rates encountered in a consecutive, all-inclusive cohort of single-stage bilateral DAA THA performed at the Straub Medical Center in Honolulu, Hawai'i, from January 2016 to May 2018. A total of 99 patients were included with a mean age of 64.7 ± 10.1 (mean ± standard deviation) years. The sample consisted of 43 (43.4%) males. Mean BMI was 27.0 ± 5.3 kg/m. The racial composition consisted of 50 (50.5%) Asian, 37 (37.4%) Caucasian, 8 (8.1%) Hawaiian/Pacific Islander, 1 (1.0%) African-American, 3 (3.0%) undisclosed. Mean operating time was 180 ± 23 minutes. Mean intraoperative blood loss was 386 ± 75 mL, and 11 (11.1%) patients received a postoperative allogenic blood transfusion. There were no major intraoperative complications. The only major local complication observed was one patient who developed high-grade heterotopic ossification requiring surgery. No major systemic complications occurred. The overall complication rate was 0.5%. In conclusion, we demonstrate that single-stage bilateral DAA THA is a safe option for the treatment of bilateral hip pathology in a wide spectrum of patients.
全髋关节置换术（THA）是一种常见的手术，患者通常需要双侧置换。同期单阶段双侧THA具有诸多优势，而THA的直接前路手术（DAA）非常适合该手术方式。在夏威夷，单阶段双侧DAA THA尚未被广泛应用于主要临床实践，目前，关于异质患者群体中单阶段双侧DAA THA术后患者预后的研究有限。在本研究中，我们介绍了2016年1月至2018年5月在夏威夷檀香山斯特劳布医疗中心进行的连续、全面的单阶段双侧DAA THA队列中所遇到的术中及90天并发症发生率的经验。共纳入99例患者，平均年龄为64.7±10.1（均值±标准差）岁。样本包括43例（43.4%）男性。平均体重指数为27.0±5.3kg/m²。种族构成包括50例（50.5%）亚洲人、37例（37.4%）白种人、8例（8.1%）夏威夷/太平洋岛民、1例（1.0%）非裔美国人、3例（3.0%）未披露。平均手术时间为180±23分钟。平均术中失血量为386±75mL，并11例（11.1%）患者接受了术后异体输血。术中无重大并发症。观察到的唯一主要局部并发症是1例患者发生了需要手术治疗的高级别异位骨化。未发生重大全身并发症。总体并发症发生率为0.5%。总之，我们证明单阶段双侧DAA THA是治疗广泛患者双侧髋关节病变的安全选择。
