Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2025; 16(8): 102298
Published online Aug 18, 2025. doi: 10.5312/wjo.v16.i8.102298
Single staged bilateral total hip replacement and its outcomes: A cross-sectional study
Hemant Sharma, Rajesh Verma, Lalit Kumar, Asgar Ali, Guruditta Khurana, Vishal Gurnani, Shallini Mittal, Nikita Jajodia
Hemant Sharma, Rajesh Verma, Lalit Kumar, Asgar Ali, Guruditta Khurana, Vishal Gurnani, Nikita Jajodia, Department of Orthopedics & Spine Surgery, Marengo Asia Hospitals Gurugram, Gurgaon 122011, Haryana, India
Shallini Mittal, Department of Radiology, Marengo Asia Hospitals Gurugram, Gurgaon 122011, Haryana, India
Co-first authors: Hemant Sharma and Rajesh Verma.
Author contributions: Sharma H and Verma R contribute equally to this study as co-first authors; all authors have contributed in study ideation and manuscript writing; Sharma H was responsible for principal investigator, study design, and data analysis; Verma R, Kumar L was responsible for study design and manuscript writing; Ali A, Khurana G, Gurnani V, Mittal S, and Jajodia N was responsible for manuscript writing and data analysis.
Institutional review board statement: Given the nature of the study, the EC granted exemption from review since the study held less than minimal risk where there were no linked identifiers.
Informed consent statement: The Informed consent statement was waived from the institutional review board.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The data can be made available on request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikita Jajodia, Department of Orthopedics & Spine Surgery, Marengo Asia Hospitals Gurugram, Sector - 56, Gurgaon 122011, Haryana, India. jalannikita@gmail.com
Received: October 14, 2024
Revised: December 27, 2024
Accepted: July 25, 2025
Published online: August 18, 2025
Processing time: 297 Days and 21.2 Hours
Abstract
BACKGROUND

Bilateral hip disorder is a common finding that can occur in approximately 42% of the population with osteoarthritis. It is estimated that 25% individuals with osteoarthritis requiring total hip replacement (THR) may require a bilateral replacement. This has resulted in the test of the greatest strategy to run single staged bilateral hip replacement while addressing the outcomes to achieve swift and cost-effective patient recovery.

AIM

To assess the outcomes and cost effectiveness of bilateral THR (B/L THR) at our tertiary care hospital.

METHODS

Retrospective observational cross- sectional study was undertaken from Jan 2018 to July 2023 to assess the clinical outcomes of patients who underwent single stage B/L THR.

RESULTS

Data of 75 patients were analysed. The mean age was 36 years. Our complication rate was 4.0% including acute coronary syndrome, intra-operative acetabular fracture and paralytic ileus. The re-admission rate was 4%.

CONCLUSION

The choice of sequential or bilateral hip replacement is controversial. While, our study showed that bilateral hip replacement is safe and cost effective. As surgeons, we were careful in patient selection (low American Society of Anesthesiologist score). Though more than 50% of our B/L THR patients were obese [body mass index (BMI) > 25], our outcomes were equivalent to normal BMI patients with lower risk of complication as well as early ambulation. Systemic complication deep vein thrombosis and pulmonary embolism were handled prophylactively by close monitoring, use of mechanical and pharmacological agents along with anticoagulants. Patients who require THR, often require them bilaterally and single stage replacement thus offers early restoration of an individual into their activities of daily living with minimal complications. Our findings support the use of single-stage B/L THR as a viable option for bilateral hip disorders, having favourable outcomes.

Keywords: Bilateral hip replacement; Outcomes; Blood loss; Co-morbidities; Uncemented; Avascular necrosis

Core Tip: Requirements of total hip arthroplasty (THA) is estimated to increase in coming times. Targeted patient selection can be instituted while undertaking THA in order to support favourable patient outcomes.