Ein- und zweizeitiger bilateraler Hüftgelenksersatz bei Dysplasiecoxarthrosen: eine vergleichende Analyse von 30 Patienten

Abstract

Dysplastic coxarthritis usually occurs earlier than primary coxarthritis. As a rule dysplastic coxarthritis mostly affects young and active individuals. Bilateral coxarthritis may lead to severe impairment requiring surgical replacement of both hip joints, as the patients are frequently dissatisfied with the substitution of one joint alone. In a retrospective study, 15 patients with bilateral hip dysplasia who had received total endoprostheses in both hip joints in a one-stage procedure (group A) were compared to 15 patients with bilateral dysplasia who had been operated on bilaterally in two stages (group B). Group B was subdivided into B1 (first side) and B2 (second side). All dysplasias were classified according to Hartofilakidis and Crowe. On the first postoperative day, group A experienced a mean drop of 33.9% in haemoglobin values, group B1 a mean drop of 25.1% and group B2 a mean drop of 26.3%. Patients of groups A/B1/B2 received on average 1.7/1.1/1.3 units of autologous blood and 1.2/0.1/0.3 units of foreign blood, respectively. Both groups experienced an improvement in their quality of life due to marked improvements in their Harris Hip Score and UCLA Score. Group A had no higher rate of complications. Although the single-stage procedure involved greater effort in terms of physiotherapy, patients preferred bilateral implantation of total hip endoprosthesis in a single surgical session because they needed to undergo the process of operation, mobilisation and rehabilitation only once.