One-stage bilateral hip arthroplasty

Abstract

Introduction: The unilateral total hip arthroplasty is a routine surgical intervention, but in the mean time in several institutions over the world, they perform also bilateral total hip arthroplasty as a one-stage surgery, with different indications. Objective: The aim of this study is to present through our cases and through the international literature the indication criteria, the absolute and relative contraindications, and the potential difficulties of one-stage bilateral hip arthroplasty, showing also the real state of this intervention in our healthcare and financial situation. Method: In this publication, we review - in relation to our five cases - the possibilities of bilateral total hip arthroplasty, their indications and differences compared to the unilateral intervention, and also its financial background. Results: We had neither surgical nor internal medicine complications. Comparing to unilateral hip arthroplasty, patients needed no higher quantity of blood transfusion, but the hospitalization period was 1,5-2 times longer in our cases. Difficulties of mobilization were according more to their internal medical status. Conclusion: According to our experience, the one-stage bilateral hip arthroplasty, with well considered indication range, can be performed safely in adequate internal medicine state of the patient, involving the cardiology and reumatology specialist, with careful anesthesia preparation. The financial side of this intervention is not yet solved at the National Health Insurance Fund of Hungary.