Cheng Ryan, Belsky Mikaela S, Nguyen Joseph T, Chiu Yu-Fen, Kahlenberg Cynthia A, Figgie Mark P, Driscoll Daniel A
Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York.
Grossman School of Medicine, New York University, New York, New York.
J Arthroplasty. 2025 Apr;40(4):971-977.e1. doi: 10.1016/j.arth.2024.10.005. Epub 2024 Oct 16.
Patients who undergo total hip arthroplasty (THA) oftentimes have severe osteoarthritis in both hips and may consider staged or simultaneous bilateral THA (bTHA). The goal of this study was to compare the total workdays missed following staged and simultaneous bTHA performed via either postero-lateral (PA) or direct anterior approach (DAA).
Patients who were (1) employed, (2) underwent a staged (within 12 months) or simultaneous bTHA at our institution between February 1, 2016, and December 31, 2021, (3) completed a return-to-work questionnaire, and (4) had the same surgical approach for both THAs were included. The primary outcome of interest was the total days of work missed.
We identified 78 employed patients who had undergone staged bTHA (62 PA, 16 DAA) and 76 patients (44 PA, 32 DAA) who underwent simultaneous bTHA, and had completed the return-to-work questionnaire. Simultaneous bTHA patients missed an average of 25.6 days of work (SD: 14.3 days) compared to staged bTHA patients, who missed an average of 36.9 days of work (SD: 23.4) when combining days missed from both operations (P < 0.001). In multivariate mixed regression analysis adjusted for sex, age, body mass index, American Society of Anesthesiologists status, type of work, and surgical approach, the staged bTHA group missed a mean of 8.2 more days of work (SD: 3.3) compared to the simultaneous bTHA group (95% confidence interval: 1.8 to 14.7, P = 0.013).
Employed patients who underwent simultaneous bTHA missed an average of 8.2 fewer days of work compared to those who were treated with staged bTHA. These findings may help surgeons counsel their employed patients who have bilateral hip osteoarthritis and are considering surgical treatment.
IV, retrospective cohort study.
接受全髋关节置换术（THA）的患者通常双侧髋关节都患有严重骨关节炎，可能会考虑分期或同期双侧全髋关节置换术（bTHA）。本研究的目的是比较经后外侧（PA）或直接前方入路（DAA）进行分期和同期bTHA后错过的总工作日数。
纳入符合以下条件的患者：（1）有工作；（2）在2016年2月1日至2021年12月31日期间在本机构接受分期（12个月内）或同期bTHA；（3）完成复工调查问卷；（4）两次THA手术入路相同。主要观察指标是错过的总工作日数。
我们确定了78例接受分期bTHA的有工作患者（62例PA入路，16例DAA入路）和76例接受同期bTHA的患者（44例PA入路，32例DAA入路），他们均完成了复工调查问卷。同期bTHA患者平均错过25.6个工作日（标准差：14.3天），而分期bTHA患者两次手术错过的工作日数合并后平均为36.9天（标准差：23.4天）（P<0.001）。在对性别、年龄、体重指数、美国麻醉医师协会分级、工作类型和手术入路进行调整的多变量混合回归分析中，分期bTHA组比同期bTHA组平均多错过8.2个工作日（标准差：3.3）（95%置信区间：1.8至14.7，P=0.013）。
与接受分期bTHA治疗的有工作患者相比，接受同期bTHA治疗的患者平均少错过8.2个工作日。这些发现可能有助于外科医生为患有双侧髋关节骨关节炎且正在考虑手术治疗的有工作患者提供咨询。
IV，回顾性队列研究。
