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Meta-Analysis
. 2019 Sep;98(39):e16774.
doi: 10.1097/MD.0000000000016774.

Comparison of mortality and complications between bilateral simultaneous and staged total hip arthroplasty: A systematic review and meta-analysis

Liangku Huang  1 , Tao Xu  2 , Peng Li  1 , Yuben Xu  1 , Lei Xia  1 , Zandong Zhao  1
Affiliations
Meta-Analysis

Comparison of mortality and complications between bilateral simultaneous and staged total hip arthroplasty: A systematic review and meta-analysis

Liangku Huang et al. Medicine (Baltimore). 2019 Sep.

Abstract

Background: Total hip arthroplasty (THA) relieves pain and restores function in patients with severe rheumatoid arthritis and osteoarthritis. Over the past few decades, several authors have attempted to assess the efficacy and safety of simultaneous bilateral THA compared with staged bilateral THA. The purpose of this meta-analysis is to compare the mortalities and complications between simultaneous bilateral THA and staged bilateral THA.

Methods: A literature search to identify eligible studies was undertaken to identify all relevant articles published until August 2018. We included studies that compared simultaneous bilateral THA and staged bilateral THA and their effects on mortality and complications. The outcomes included mortality, the occurrence of deep venous thrombosis (DVT), the occurrence of pulmonary embolism (PE), respiratory complications, cardiovascular complications, digestive system complications and the occurrence of dislocation. Stata 12.0 was used for the meta-analysis.

Results: Nineteen studies involving 59,257 patients were identified; among them, 16,758 patients were selected for treatment with simultaneous bilateral THA, and 42,499 patients were chosen for the purpose of staged bilateral THA. The meta-analysis results demonstrated that there was no significant difference between simultaneous bilateral THA and staged bilateral THA in terms of mortality (risk ratio [RR] = 1.15, 95% CI = 0.76, 1.74; P = .520). Compared with staged bilateral THA, simultaneous bilateral THA was associated with a reduction in the occurrence of DVT, PE and respiratory complications (P < .05). There were no significant differences in the cardiovascular complications, digestive system complications or the occurrence of dislocation and infection (P = .057).

Conclusions: We observed that the prevalence of DVT, PE and respiratory complications was considerably lower with the use of simultaneous bilateral THA than with the use of staged bilateral THA. Thus, simultaneous bilateral THA is a considerably safer procedure than staged bilateral THA in selected THA patients.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow of trials in the meta-analysis.
Figure 2
Figure 2
The risk of bias summary: +, no bias; –, bias; ?, bias unknown.
Figure 3
Figure 3
Forest plots of the included studies comparing the occurrence of mortality.
Figure 4
Figure 4
Forest plots of the included studies comparing the occurrence of DVT. DVT = deep venous thrombosis.
Figure 5
Figure 5
Forest plots of the included studies comparing the occurrence of PE. PE = pulmonary embolism.
Figure 6
Figure 6
Forest plots of the included studies comparing respiratory complications.
Figure 7
Figure 7
Forest plots of the included studies comparing cardiovascular complications.
Figure 8
Figure 8
Forest plots of the included studies comparing digestive system complications.
Figure 9
Figure 9
Forest plots of the included studies comparing the occurrence of dislocation.
Figure 10
Figure 10
Forest plots of the included studies comparing the occurrence of infection.
See this image and copyright information in PMC

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References

    1. Jaffe WL, Charnley J. Bilateral Charnley low-friction arthroplasty as a single operative procedure. A report of fifty cases. Bull Hosp Joint Dis 1971;32:198–214. - PubMed
    1. Zhu XT, Chen L, Lin JH. Selective COX-2 inhibitor versus non-selective COX-2 inhibitor for the prevention of heterotopic ossification after total hip arthroplasty: A meta-analysis. Medicine (Baltimore) 2018;97:e11649. - PMC - PubMed
    1. Shao H, et al. Bilateral total hip arthroplasty: 1-Stage or 2-Stage? A meta-analysis. J Arthroplasty 2017;32:689–95. - PubMed
    1. Reuben JD, et al. Cost comparison between bilateral simultaneous, staged, and unilateral total joint arthroplasty. J Arthroplasty 1998;13:172–9. - PubMed
    1. Odum SM, et al. A cost-utility analysis comparing the cost-effectiveness of simultaneous and staged bilateral total knee arthroplasty. J Bone Joint Surg Am 2013;95:1441–9. - PubMed

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