Increased conditional risk of recurring complications with contralateral total hip arthroplasty surgery
The Bone & Joint Journal Jun 06, 2019
Roberts HJ, et al. - Given a rise in demand for arthroplasty and cruciality of perioperative risk assessment and counseling for shared decision making, researchers sought to determine if complications that occur after a unilateral hip arthroplasty predict complications following surgery of the contralateral hip. The incidence and recurrence of complications following the first- and second-stage operations in staged bilateral total hip arthroplasty (BTHAs) were determined using nationwide linked discharge data from the Healthcare Cost and Utilization Project between 2005 and 2014. They analyzed a total of 13,829 patients (5790 men and 8039 women) who underwent staged BTHAs. For eight of the 12 outcomes evaluated, patients experiencing the outcome after the first arthroplasty vs those who did not experience the complication showed significantly higher likelihood and odds of developing that same complication following the second arthroplasty. This was valid for digestive complications, urinary complications, hematoma, deep vein thrombosis, pulmonary embolism, deep hip infection, superficial hip infection, and mechanical malfunction. Hence they recommend appropriately counseling patients who experience these complications after unilateral hip arthroplasty regarding their risk profile prior to undergoing staged contralateral hip arthroplasty.
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