Single Stage Bilateral Total Hip Replacement Versus Staged Two Sessions Bilateral Total Hip Replacement: A Functional Outcome

Abstract

Bilateral total hip replacement (BTHR) is an effective surgical solution for patients with bilateral hip osteoarthritis and avascular necrosis. The procedure can be performed either as a single-stage operation or as two staged-session surgeries. To compare single-stage bilateral total hip replacement with staged two-session bilateral total hip replacement, with particular emphasis on functional outcomes and early postoperative recovery. A prospective comparative observational study. Sixty patients aged 45-65 years with bilateral hip osteoarthritis or avascular necrosis and without any major comorbidity were enrolled. Thirty patients were operated on in a single stage, and 30 had the two hips replaced separately with an interval of 6-12 weeks. All surgeries were conducted through a posterolateral approach. Measures were total hospital stay, total rehabilitation time, and time to symmetric normal gait 12 months post-surgical follow-up using the OHS. Baseline demographic characteristics and underlying diagnoses were comparable between groups. The single-stage group demonstrated a significantly shorter hospital stay, reduced rehabilitation duration, and earlier achievement of symmetric normal gait compared with the staged group (P<0.001). Additionally, functional outcome was significantly higher in the single-stage group, as reflected by superior OHS scores at 12 months (P<0.001). Single-stage bilateral total hip replacement provides a better early functional recovery, shorter hospital stay, and faster rehabilitation than staged two-session surgery in properly selected patients. Our results justify single-stage BTHR as a safe and effective option when selection of patients and preoperative optimization are well thought out.