To compare the outcome of simultaneous versus two staged Non-cemented Total hip Arthroplasty (THA) in terms of cost effectiveness and improvement in Harris Hip Score (HHS)
Material and methodology: This comparative prospective study was conducted from 2008 to 2012. Total 100 patients with 200 hips fulfilling the inclusion and exclusion criteria was included in this study. Non-cemented THA was performed in all these patients. Fifty patients each were placed in group A and B who were managed with simultaneous bilateral THA and staged bilateral non-cemented THA respectively. Patients in both the groups were matched. Duration of surgery, preoperative and postoperative HHS, duration of stay in hospital, time to return to work and complications were the main variables that were evaluated.
Results: The mean preoperative and postoperative HHS in group A was 53.08±8.178 (36-69) and 92.62±2.26 (90-97) respectively with p-value <0.0001. Similarly mean preoperative and postoperative HHS in group B was 57.04±5.08 (45-68) and 91.58±2.43 (87-96) respectively with p-value <0.0001. Mean hospital stay in group A was 6.48±0.84 days (5-9 days) while that in group B was 14.2±1.84 days (11-18 days) and this difference was statistically significant. Though the duration to return to work in both the group was not significantly (6.32±0.82 versus 6.54±0.97 months, P-value >0.05) different but that interval of 3 months between the bilateral THA placed extra time loss from work in group B patient adding to extra financial burden to these patients.
Conclusion: It can be concluded that simultaneous bilateral THA is cost effective with same level of functional outcome when compared to staged bilateral THA. However, the long-term outcome, the effect of the simultaneous and staged procedure on psychological condition of the patient and family needs further study.