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J Am Acad Orthop Surg, Vol 10, No 3, May/June 2002, 217-221.
© 2002 the American Academy of Orthopaedic Surgeons
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Single-Stage Bilateral Total Hip Arthroplasty

William Macaulay, MD, Eduardo A. Salvati, MD, Thomas P. Sculco, MD and Paul M. Pellicci, MD

Dr. Macaulay is Director, Center for Hip and Knee Replacement, Columbia University, New York, NY. Dr. Salvati is Director, Hip and Knee Service, Hospital for Special Surgery, New York. Dr. Sculco is Chief, Department of Orthopaedic Surgery, Hospital for Special Surgery. Dr. Pellicci is Attending Orthopaedic Surgeon, Hospital for Special Surgery.

Reprint requests: Dr. Macaulay, Rm 1146, PH 11th Floor, 622 West 168th Street, New York, NY 10032.

The number of single-stage bilateral total hip arthroplasties done each year is increasing. The risk of postoperative complications in medically stable patients is acceptable; complications are approximately 1.3 times more frequent than with unilateral total hip arthroplasty. Although there are no absolute indications for a single-stage bilateral total hip arthroplasty, the procedure is usually contraindicated in patients with such comorbidities as heart disease, pulmonary insufficiency, or diabetes, and it is absolutely contraindicated in patients with a documented patent ductus arteriosus or septal defect. The primary postoperative concern is that the cardiopulmonary insult associated with two surgical wounds and surgeries can lead to an increase in thromboembolic events. The cost for single-stage bilateral total arthroplasty is less than that for a two-stage bilateral total hip arthroplasty, with savings predominantly due to reduced length of acute hospital stay. However, the decision to undergo single-stage bilateral total hip arthroplasty is one that must be made in concert with the patient.




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