There are No Differences in Early Complications or One-Year Patient-Reported Outcomes Between Single-Stage Bilateral and Unilateral Total Hip Arthroplasty Performed in Patients 70 Years and Older.

Background

Despite the potential benefits of single-stage bilateral total hip arthroplasty (ssBTHA), its safety in older patients remains unclear. This study compared early postoperative complications and patient-reported outcomes (PROs) between patients 70 years and older undergoing ssBTHA and similar-aged patients undergoing unilateral total hip arthroplasty (UTHA).

Methods

Data were collected retrospectively for 334 patients 70 and older who underwent UTHA (271 patients) or ssBTHA (63 patients) by a single, high-volume arthroplasty surgeon between July 2017 and July 2022. Patient demographics, perioperative variables, early postoperative complications (within 90 days), and PROs up to one year were collected. Patient demographics were comparable between cohorts, except for the proportion of women, which was higher in the ssBTHA cohort (P = 0.043). Continuous variables were compared using t-tests and categorical variables using Chi-square or Fisher's exact tests.

Results

The ssBTHA cohort had a longer length of stay (P < 0.001), a lower proportion of patients discharged directly home (P < 0.001), and higher postoperative transfusion rates (P = 0.005) compared with the UTHA cohort. There were no statistically significant differences in 90-day emergency department (ED) visits, readmissions from the ED, venous thromboembolisms, non-revision reoperations, or revisions between cohorts. There were no differences in pre- or postoperative PROs observed through 1-year post-surgery.

Conclusion

A ssBTHA is a reasonable and safe treatment option for patients 70 years of age and older who have symptomatic bilateral hip osteoarthritis, with early postoperative complication profiles and PROs comparable to those of unilateral procedures.