Simplifying the Hip-Spine Relationship for Total Hip Arthroplasty: Introduction.

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Abstract

[Indexed for MEDLINE] 8. J Arthroplasty. 2017 Feb;32(2):689-695. doi: 10.1016/j.arth.2016.09.022. Epub 2016 Sep 28. Bilateral Total Hip Arthroplasty: 1-Stage or 2-Stage? A Meta-Analysis. Shao H(1), Chen CL(2), Maltenfort MG(3), Restrepo C(3), Rothman RH(3), Chen AF(3). Author information: (1)Orthopedics Department, Beijing Jishuitan Hospital, Beijing, China. (2)Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan. (3)Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. Comment in J Arthroplasty. 2017 Apr;32(4):1404-1405. doi: 10.1016/j.arth.2016.10.023. J Arthroplasty. 2017 Apr;32(4):1405-1406. doi: 10.1016/j.arth.2016.10.024. BACKGROUND: Total hip arthroplasty (THA) is one of the most successful orthopedic surgeries performed in the last 50 years. However, controversies still exist between conducting 1- or 2-stage bilateral THA. METHODS: Using PubMed, Ovid, Embase, and Cochrane library databases, we searched for papers written between January 1995 and October 2015 that contained the following search terms: "one-stage or two-stage" or "simultaneous or staged," and "hip" and "arthroplasty or replacement." A meta-analysis was conducted with the collected pooled data about major and minor systemic complications, surgical complications, and other perioperative data associated with 1- and 2-stage bilateral THA. Statistical analysis was performed by the Mantel-Haenszel method, and the fixed effect model was used to analyze data. RESULTS: There were 13 studies with 17,762 patients who underwent 1-stage bilateral THA and 46,147 patients who underwent 2-stage bilateral THA. One-stage bilateral THA had a lower risk of major systemic complications, less deep venous thrombosis, and shorter operative time compared with 2-stage bilateral THA. There were no significant differences in death, pulmonary embolism, cardiovascular complication, infections, minor complications, and other surgical complications between procedures. CONCLUSION: One-stage bilateral THA was superior to 2-stage bilateral THA in terms of major systemic complication, deep venous thrombosis, and surgical time compared with 2-stage bilateral THA. However, this study does not encourage performing 1-stage over 2-stage bilateral THA. Higher evidence level studies are necessary for further analysis. Copyright © 2016 Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2016.09.022