Safety of Single-Stage Bilateral Versus Unilateral Anterior Total Hip Arthroplasty
Bibliographic record
Abstract
BACKGROUND: Limited data exist on patient safety after single-stage bilateral and unilateral total hip arthroplasty (THA) through the anterior approach (AA). Therefore, the aim of this study was to compare length of stay (LOS), operative time, 90-day adverse events, 90-day readmission rate, and 1-year revision rate after single-stage bilateral and unilateral THA in matched patients. METHODS: This was a retrospective matched cohort study of prospectively collected data from 2008 to 2018 of a single-surgeon practice. We used the built-in propensity score matching formula in SPSS software and matched bilateral and unilateral patient groups on the relevant covariates of age, sex, and body mass index. This resulted in 60 patients undergoing bilateral THA and 60 patients undergoing unilateral THA. RESULTS: The average LOS was 4.7 days (interquartile range [IQR], 3 to 5 days; range, 2 to 21 days) after bilateral THA and 3.0 days (IQR, 2 to 4 days; range, 1 to 13 days) after unilateral THA (p < 0.001). The mean operative time was 140 minutes for bilateral THA and 69 minutes for unilateral THA (p < 0.001). The adverse event rate was 6.7% after bilateral THA and 5.0% after unilateral THA (p = 0.660). The 90-day readmission rate was 3.3% after bilateral THA and 5.0% after unilateral THA (p = 0.321), which also accounted for all of the revisions within the first year. CONCLUSIONS: When considering single-stage versus staged bilateral AA total hip replacement, patients can expect the same clinical outcome. Because the operative time is longer with bilateral THA, the main advantages are that the patient avoids a second anesthesia session and has an overall shorter recovery time. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".