The Journal of Hip Surgery 2021; 05(03): 091-095
DOI: 10.1055/s-0041-1729868
Original Article

Are the First and Second Hip in Staged Bilateral Total Hip Arthroplasty Equal? A Hospital Adverse Event and Perioperative Risk Comparison

Jesus M. Villa
1   Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
,
Tejbir S. Pannu
1   Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
,
Carlos A. Higuera
1   Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
,
Juan C. Suarez
2   Miami Orthopedics & Sports Medicine Institute, Baptist Health South Florida, Coral Gables, Florida
,
Preetesh D. Patel
1   Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
,
Wael K. Barsoum
1   Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, Florida
› Author Affiliations
Source of Funding The current investigation did not receive any specific grant from funding agencies in the commercial, public, or not-for-profit sectors.

Abstract

Hospital adverse events remain a significant issue; even “minor events” may lead to increased costs. However, to the best of our knowledge, no previous investigation has compared perioperative events between the first and second hip in staged bilateral total hip arthroplasty (THA). In the current study, we perform such a comparison. A retrospective chart review was performed on a consecutive series of 172 patients (344 hips) who underwent staged bilateral THAs performed by two surgeons at a single institution (2010–2016). Based on chronological order of the staged arthroplasties, two groups were set apart: first-staged THA and second-staged THA. Baseline-demographics, length of stay (LOS), discharge disposition, hospital adverse events, and hospital transfusions were compared between groups. Statistical analyses were performed using independent t-tests, Fisher's exact test, and/or Pearson's chi-squared test. The mean time between staged surgeries was 465 days. There were no significant differences in baseline demographics between first-staged THA and second-staged THA groups (patients were their own controls). The mean LOS was significantly longer in the first-staged THA group than in the second (2.2 vs. 1.8 days; p < 0.001). Discharge (proportion) to a facility other than home was noticeably higher in the first-staged THA group, although not statistically significant (11.0 vs. 7.6%; p = 0.354). The rate of hospital adverse events in the first-staged THA group was almost twice that of the second (37.2 vs. 20.3%; p = 0.001). There were no significant differences in transfusion rates. However, these were consistently better in the second-staged THA group. When compared with the first THA, our findings suggest overall shorter LOS and fewer hospital adverse events following the second.

Level of Evidence Level III.



Publication History

Received: 17 April 2020

Accepted: 25 January 2021

Article published online:
15 June 2021

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