Bonilla-Ortiz Camilo Hernán, Manrique-González Jorge Eduardo, Restrepo-Uribe Andrés, Malagón-Santos Juan Manuel, Casas-Galindo Jorge De Francisco, Muñoz-Medina Sofia, Rincón-Hoyos Jairo Alonso
Orthopaedic Surgeon, Clínica Universitaria Colombia, Fundación Universitaria Sanitas, Cra. 66 #23-46 and Cl. 170 #8-41, Bogotá, Colombia.
Orthopaedic Surgeon, Hip and Knee Specialist, Clínica Universitaria Colombia, Clínica Reina Sofía; Clínica Colsanitas, Cra. 66 #23-46 and Av. Cl. 127 #20-78, Bogotá, Colombia.
SICOT J. 2025;11:31. doi: 10.1051/sicotj/2025023. Epub 2025 May 22.
This study analyzed complication rates in two-stage bilateral Total Hip Arthroplasty (THA) across three distinct inter-stage intervals to determine the optimal timing for minimizing risk.
This was a retrospective, multicentre, analytic study. The three intervals evaluated were <2 weeks (Group A), 2-12 weeks (Group B), and >12 weeks (Group C). The primary outcomes were blood transfusions, thromboembolic events (TVE), and coronary events, and the secondary outcomes were hospital stay, respiratory complications, reintervention, and mortality. The associations between demographic characteristics and complications and the risk hazard of complications were determined.
A total of 331 patients were included: 86 in Group A, 47 in Group B, and 198 in Group C. Blood transfusions after the second THA were performed in 29.1%, 14.9%, and 7.6% of the time interval groups respectively (p = 0.000). One TVE (1.1%) was recorded in group A and 4 (2%) in group C (p = 0.613).
Two-stage bilateral THA with a time interval between both surgeries of <2 weeks presented a significantly higher rate of blood transfusions than longer time intervals between surgeries, with an HR of 2.4 (CI: 95% 1.7-3.3, p = 0.000). The incidences of thromboembolic and coronary events were similar between the different timeintervals, demonstrating that two-stage bilateral THA is safe when performed with an interval of at least 2 weeks between both surgeries.
本研究分析了两阶段双侧全髋关节置换术（THA）在三个不同的阶段间隔中的并发症发生率，以确定将风险降至最低的最佳时机。
这是一项回顾性、多中心分析研究。评估的三个间隔分别为<2周（A组）、2 - 12周（B组）和>12周（C组）。主要结局为输血、血栓栓塞事件（TVE）和冠状动脉事件，次要结局为住院时间、呼吸并发症、再次干预和死亡率。确定了人口统计学特征与并发症之间的关联以及并发症的风险危害。
共纳入331例患者：A组86例，B组47例，C组198例。在第二阶段THA后，各时间间隔组的输血发生率分别为29.1%、14.9%和7.6%（p = 0.000）。A组记录到1例TVE（1.1%），C组记录到4例（2%）（p = 0.613）。
两阶段双侧THA中，两次手术间隔时间<2周的输血率显著高于手术间隔时间较长的情况，风险比为2.4（置信区间：95% 1.7 - 3.3，p = 0.000）。不同时间间隔的血栓栓塞和冠状动脉事件发生率相似，表明两阶段双侧THA在两次手术间隔至少2周时进行是安全的。
