Shen Maoye, Jiang Wenxue, Qian Ping, Cai Gaorui, Wu Xiaona, Wang Jinghua, Ning Xianjia, Song Lixia
Department of Orthopedics, Shenzhen Third People's Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China.
Center of Clinical Epidemiology, Shenzhen Third People's Hospital and the Second Hospital Affiliated with the Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China.
Clinicoecon Outcomes Res. 2024 Oct 17;16:753-760. doi: 10.2147/CEOR.S479173. eCollection 2024.
Bilateral hip arthroplasty is a common surgical intervention for patients with bilateral hip disease. The decision between simultaneous versus staged procedures remains debated, primarily due to concerns over cost, postoperative recovery, and complication rates. This study aimed to evaluate the economic burden and clinical outcomes of simultaneous versus staged bilateral hip arthroplasty.
In this single-center, prospective study, patients who underwent bilateral hip replacement at XXX between 2021 and 2022 were included. Participants were divided into groups based on the surgical approach: simultaneous bilateral hip arthroplasty or staged bilateral hip arthroplasty. Data on costs, operation times, hospital stay lengths, and postoperative outcomes were collected and analyzed.
A total of 57 patients were studied, with 45 undergoing simultaneous and 12 staged surgeries. The total cost for staged procedures was significantly higher, with a mean difference of 63,967.54 yuan compared to simultaneous procedures. No significant difference was found in prosthesis costs between the groups. Operation times and hospital stays did not significantly differ, with averages closely aligned between the simultaneous (operation time: 3.2 hours, hospital stay: 5 days) and staged groups (operation time: 3.4 hours, hospital stay: 5.2 days). The obesity rate was higher in the simultaneous group (P < 0.05).
Simultaneous bilateral hip arthroplasty appears to be an economically favorable option, with comparable perioperative and immediate postoperative outcomes to staged procedures. These insights have significant implications for clinical practice and policy-making, suggesting that simultaneous procedures can be safely implemented for appropriate patients, potentially optimizing healthcare resources.
双侧髋关节置换术是双侧髋关节疾病患者常见的外科手术干预方式。同期手术与分期手术之间的抉择仍存在争议，主要是因为对成本、术后恢复及并发症发生率存在担忧。本研究旨在评估同期与分期双侧髋关节置换术的经济负担及临床结局。
在这项单中心前瞻性研究中，纳入了2021年至2022年在XXX接受双侧髋关节置换的患者。参与者根据手术方式分为两组：同期双侧髋关节置换术或分期双侧髋关节置换术。收集并分析了成本、手术时间、住院时长及术后结局的数据。
共研究了57例患者，其中45例行同期手术，12例行分期手术。分期手术的总成本显著更高，与同期手术相比，平均差值为63967.54元。两组之间假体成本无显著差异。手术时间和住院时间无显著差异，同期组（手术时间：3.2小时，住院时间：5天）和分期组（手术时间：3.4小时，住院时间：5.2天）的平均值相近。同期组的肥胖率更高（P<0.05）。
同期双侧髋关节置换术似乎是一种经济上更有利的选择，围手术期及术后即刻结局与分期手术相当。这些见解对临床实践和政策制定具有重要意义，表明对于合适的患者可以安全地实施同期手术，可能优化医疗资源。
