Orthopedic & Muscular System: Current Research
Open Access

Abstract

One-Stage Bilateral Total Hip Replacement is Cost-Saving

Ola Rolfson, Georgios Digas, Peter Herberts, Johan Karrholm, Fredrik Borgstrom, Goran Garellick and Goran Garellick

Many patients suffer from bilateral hip disease. For these patients two-stage bilateral total hip replacement (THR) is more common than a one-stage procedure because of fear of complications associated with one-stage surgery. However, many studies are in favour of one-stage bilateral THR in healthy and young patients.

We investigated costs, complications and patient-reported outcome related to one-stage bilateral THR. Unilateral THR was used as a reference. Thirty-two patients with one-stage bilateral THR were prospectively followed for six years (bilateral group). A matched reference population of 32 patients with unilateral THR was assembled (unilateral group). Medical records, individual data from the Swedish Hip Arthroplasty Register, the Swedish Social Insurance Administration and local data on cost per patient were used for the analyses. For non-retired patients, the duration and costs for sick leave during the first postoperative year were similar in both groups. The rate of complications and their severity were similar in both groups. Using cost data from this study in a theoretical model, comparing one- and two-staged procedures showed a 24% reduction in hospital and sick-leave costs in favour of the one-stage procedure. Our results indicate that the one-stage procedure is cost-saving compared to two-stage procedures for patients with indication for bilateral THR.