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Simultaneous and staged bilateral total hip arthroplasty: a Danish nationwide study.
MedLine Citation:
PMID:  23912419     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days readmissions and 90 days mortality after BSTHA and BTHA on a nationwide basis.
MATERIALS AND METHODS: All bilateral primary total hip arthroplasties performed in Denmark from January 1, 2010 to June 31, 2011 were identified using data from the Danish National Patient Registry. The staged procedures were divided into early staged BTHA (0-6 months) and late staged BTHA (6-18 months).
RESULTS: 103 patients underwent BSTHA, 370 underwent BTHA (0-6 months) and 207 underwent BTHA (6-18 months). Median total LOS was 4 days (IQR 3) after BSTHA vs. 6 days (3) after both BTHA (0-6 months) and BTHA (6-18 months) (p < 0.001). There were no deaths in the BSTHA group vs. 1 death in each BTHA group ≤90 days postoperatively (0.3 and 0.5 %, respectively) (p = 0.755). The readmission rate ≤30 days was 1.9 % after BSTHA vs. 8.9 % (cumulated) after BTHA (0-6 months) and 15.9 % (cumulated) after BTHA (6-18 months) (p < 0.001).
CONCLUSIONS: If patients are carefully selected for BSTHA, the procedure appears to be safe when combined with a fast-track protocol in Denmark. We found significantly lower readmission rates and shorter total LOS in the BSTHA group compared with the BTHA groups, potentially reflecting selection bias. The results should stimulate to evaluate BSTHA in a randomised controlled trial or a detailed prospective, large multicenter study with a fast-track protocol regarding morbidity, convalescence and mortality.
Martin Lindberg-Larsen; Christoffer Calov Joergensen; Henrik Husted; Henrik Kehlet
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-4
Journal Detail:
Title:  Archives of orthopaedic and trauma surgery     Volume:  -     ISSN:  1434-3916     ISO Abbreviation:  Arch Orthop Trauma Surg     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-8-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011043     Medline TA:  Arch Orthop Trauma Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark,
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