Orthopedic Department, Orthopedic Surgery Research Center (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Heidelberg Medical Hospital, Heidelberg, Germany.
J Orthop Surg Res. 2022 Aug 13;17(1):392. doi: 10.1186/s13018-022-03281-4.
Total hip arthroplasty is a common orthopedic surgery for treating primary or secondary hip osteoarthritis. Bilateral total hip replacement could be performed in a single stage or two separate stages. Each surgical procedure's reliability, safety, and complications have been reported controversially. This study aimed to review the current evidence regarding the outcomes of simultaneous and staged bilateral total hip arthroplasty.
We conducted a meta-analysis using MEDLINE, EMBASE, Web of Science, and Scopus databases. Eligible studies compared complications and related outcomes between simultaneous and staged bilateral THA. Two reviewers independently screened initial search results, assessed methodological quality, and extracted data. We used the Mantel-Haenszel method to perform the meta-analysis.
In our study, we included 29,551 patients undergoing simBTHA and 74,600 patients undergoing stgBTHA. In favor of the simBTHA, a significant reduction in deep vein thrombosis (DVT) and systemic, local, and pulmonary complications was documented. However, we evidenced an increased pulmonary embolism (PE) and periprosthetic fracture risk in simBTHA. In the simBTHA, total blood loss, length of hospital stay, and total cost were lower.
This meta-analysis shows that simultaneous bilateral THA accompanies fewer complications and lower total cost. Well-designed randomized controlled trials are needed to provide robust evidence.
全髋关节置换术是治疗原发性或继发性髋关节骨关节炎的常见骨科手术。双侧全髋关节置换术可分两期进行，也可一期完成。两种手术方法的可靠性、安全性和并发症已被报道存在争议。本研究旨在回顾同期和分期双侧全髋关节置换术的结果的现有证据。
我们使用 MEDLINE、EMBASE、Web of Science 和 Scopus 数据库进行荟萃分析。合格的研究比较了同期和分期双侧全髋关节置换术的并发症和相关结局。两位审查员独立筛选初始搜索结果、评估方法学质量并提取数据。我们使用 Mantel-Haenszel 法进行荟萃分析。
在我们的研究中，我们纳入了 29551 例接受 simBTHA 和 74600 例接受 stgBTHA 的患者。simBTHA 有利于降低深静脉血栓形成（DVT）和全身、局部和肺部并发症的风险。然而，我们发现 simBTHA 中肺栓塞（PE）和假体周围骨折的风险增加。在 simBTHA 中，总失血量、住院时间和总费用较低。
这项荟萃分析表明，同期双侧全髋关节置换术并发症较少，总费用较低。需要设计良好的随机对照试验来提供可靠的证据。
