Journal List > J Korean Hip Soc > v.23(3) > 1048726

Hwang, Kwon, and Chung: Comparison of Simultaneous Bilateral Cementless Total Hip Replacement with Staged Bilateral Cementless Total Hip Replacement in High Risk Anesthesia Group

Abstract

Purpose

Simultaneous bilateral total hip replacement (THR) has some advantages, but the efficacy of simultaneous bilateral THR is still controversial in patients with high risk ASA grade. Presently, we compared simultaneous bilateral to staged THR in high-risk patients according to the ASA grade.

Materials and Methods

We retrospectively compared 60 high risk patients (ASA grade 3 and 4) with simultaneous cementless total hip replacements with a matched group of 60 patients with staged cementless total hip replacements between January, 1991 and June, 2009. Significance was determined to be p-value < 0.05.

Results

Postoperative cardio-vascular complication was found in one case of simultaneous THR, and pulmonary thromboembolism was found in two cases of staged THR and in three cases of simultaneous THR. Wound infection was found in three cases of staged THR and in two cases of simultaneous THR. Delirium was found in four cases of staged THR and in five cases of simultaneous THR. Dislocation developed in two cases of staged THR and in three cases of simultaneous THR. Blood loss was higher in the staged group, but the transfusion amount was higher in the simultaneous group. Postoperative ambulation was initiated earlier in staged THR, but at the final follow-up no statistical significance was observed. Admission time and cost were reduced in simultaneous THR.

Conclusion

It is considered safe to perform simultaneous cementless bilateral THA in patients with high anesthetic risk, if meticulous preoperative evaluation is done.

Figures and Tables

Table 1
Number of High Risk Anesthesia Patients (ASA Grade 3 & 4)
jkhs-23-200-i001

*ASA: American Society of Anesthesiolists

Table 2
Comparison Between Staged and Simultaneous Groups
jkhs-23-200-i002
Table 3
Etiologies in Both Groups
jkhs-23-200-i003
Table 4
Outcome
jkhs-23-200-i004

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