Please use this identifier to cite or link to this item:
Title: Mortality and implant survival with simultaneous and staged bilateral total hip arthroplasty: Experience from the Australian Orthopaedic Association National Joint Replacement Registry.
Epworth Authors: de Steiger, Richard
Other Authors: Calabro, Lorenzo
Yong, Mostyn
Whitehouse, Sarah
Crawford, Ross
Hatton, Alesha
Keywords: Total Hip Arthroplasty
Total Hip Replacement
Bilateral Disease
Patient Selection
Staged THA
Causes of Revision
Australian Orthopaedic National Joint Replacement Registry
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Apr-2020
Publisher: Elsevier
Citation: The Journal of Arthroplasty. 2020 Apr 21.
Abstract: Background Total hip arthroplasty (THA) is an effective procedure for relieving pain and restoring function in osteoarthritis. A significant proportion of patients have severe disease bilaterally. Consensus regarding safety and selection of patients for simultaneous bilateral THA, or the optimal timing for staged THA has not been reached. The aim of this study is to compare rates, causes of revision and 30-day mortality between simultaneous and staged bilateral THA using data from the Australian Orthopaedic National Joint Replacement Registry (AOANJRR). Methods Data for 12,359 bilateral THA procedures was collected from September, 1999 to December, 2017. Rates and causes of revision and 30-day mortality were obtained for simultaneous bilateral and staged procedures with intervals of 1 day-6 weeks, 6 weeks-3 months and 3 months-6 months. Yearly cumulative percent revision (CPR) or survival (CPS) with 95% confidence intervals calculated by the Kaplan-Meier method and adjusted hazard ratios were used for comparisons. Results Thirty-day mortality is lower in patients who have bilateral procedures within 6 months, regardless of timing, than those who have unilateral procedures (0.06% vs 0.18%). Staged bilateral THA had a significantly lower mortality than simultaneous bilateral THA (OR 0.175, 95% CI 0.04-0.78, p=0.022). When separate time intervals were compared, no significant differences were seen. Bilateral 6wk-3mths has a higher rate of revision from 1.5y-2yrs compared to same day bilaterals (HR=2.39, 95% CI 1.12, 5.09, p=0.024). There were no other significant differences in the rate of revision between groups. The most common reasons for revision were fracture, loosening and infection. Simultaneous bilateral procedures have a significantly higher rate of revision for fracture compared to staging 3-6 months (HR=1.96 (1.27, 3.03), p=0.002). Conclusion This study demonstrates that bilateral THA has a low mortality rate regardless of time interval between procedures. Simultaneous and staged bilateral THA have similar rates of revision.
DOI: 10.1016/j.arth.2020.04.027
ISSN: 0883-5403
Journal Title: The Journal of Arthroplasty
Type: Journal Article
Affiliated Organisations: Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
South Australian Health and Medical Research Institute, Adelaide, Australia
Type of Clinical Study or Trial: Comparative Study
Appears in Collections:Musculoskeletal

Files in This Item:
There are no files associated with this item.

Items in Epworth are protected by copyright, with all rights reserved, unless otherwise indicated.