Document Detail


One- or two-stage bilateral metal-on-metal hip resurfacing arthroplasty.
MedLine Citation:
PMID:  17905948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients considered suitable for total hip resurfacing arthroplasty often have bilateral disease. The peri-operative complications, transfusion requirements, hospital stay, outcome and costs in patients undergoing one-stage bilateral total hip resurfacing were compared with a group of patients undergoing a two-stage procedure. A total of 92 patients were included in the study, of which 37 (40%) had a one-stage and 55 (60%) had a two-stage resurfacing. There were no significant differences in age, gender, or American Society of Anaesthesiologists grade between the groups (p = 0.31, p = 0.23, p = 0.13, respectively). There were three systemic complications in the one-stage group (8.1%) and one in the two-stage group (1.8% of patients; 0.9% of procedures). There was no significant difference in the complication rate (p = 0.72) or the transfusion requirements (p = 0.32) between the two groups. The one-stage group had a reduced total hospital stay of five days (95% confidence interval 4.0 to 6.9; p < 0.001), reduced length of time to completion of all surgery of five months (95% confidence interval 2.6 to 8.3; p < 0.001), and the reduced cost was 35% less than that of a two-stage procedure. However, the total anaesthetic time was significantly longer for the one-stage group (p < 0.001; 95% confidence interval 31 to 52). This study demonstrates that consideration should be given to one-stage surgery for patients with bilateral symptomatic disease suitable for metal-on-metal hip resurfacing. A one-stage procedure appears to have benefits for both the patient and the hospital without additional complications.
Authors:
C W McBryde; K Dehne; A M Pearson; R B C Treacy; P B Pynsent
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  89     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-10-01     Completed Date:  2008-01-17     Revised Date:  2010-11-10    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  1144-8     Citation Subset:  AIM; IM    
Affiliation:
Research and Teaching Centre, Royal Orthopaedic Hospital, Bristol Road South, Northfield, Birmingham B31 2AP, UK. cwmcbryde@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arthroplasty, Replacement, Hip / economics,  methods*
Blood Transfusion
Child
Confidence Intervals
Female
Hip Prosthesis*
Humans
Intraoperative Complications*
Length of Stay
Male
Middle Aged
Postoperative Complications*
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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