EARLY OUTCOMES TWO-STAGE BILATERAL TOTAL HIP ARTHROPLASTY FOR BILATERAL OSTEONECROSIS OF THE FEMORAL HEAD IN CAN THO UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL
Main Article Content
Abstract
Background: Osteonecrosis of the femoral head frequently presents as a bilateral condition and remains one of the most common indications for total hip arthroplasty in adults. In recent years, staged bilateral total hip arthroplasty has been increasingly adopted in clinical practice. However, data regarding patient characteristics and treatment outcomes of this approach in Vietnam remain limited. Objectives: To describe clinical and radiographic characteristics and to evaluate treatment outcomes in patients with bilateral osteonecrosis of the femoral head treated with staged bilateral total hip arthroplasty. Materials and Methods: This single-center, retrospective cross-sectional study included 30 patients diagnosed with bilateral osteonecrosis of the femoral head who underwent staged bilateral total hip arthroplasty at Can Tho University of Medicine and Pharmacy Hospital between January 2022 and December 2025. Results: The mean age of the patients was 55.47 ± 9.62 years, with a male-to-female ratio of 5:1. Most patients presented with progressive hip pain exacerbated by prolonged walking or standing. Radiographic evaluation showed that 96.7% of hips were classified as Ficat–Arlet stage III or IV, with a high prevalence of femoral head deformity and joint space narrowing. Postoperatively, the mean HHS improved significantly from 42.7 ± 8.3 to 85.6 ± 7.8, while the mean VAS pain score decreased to 3.5 ± 0.9. Many patients achieved satisfactory functional reintegration within 4–12 weeks after surgery. The complication rate was low, with only one case of postoperative infection (3.3%), and no cases of femoral stem loosening or clinically significant limblength discrepancy were observed. Conclusion: Staged bilateral total hip arthroplasty is a safe, effective, and feasible treatment option for patients with advanced bilateral osteonecrosis of the femoral head. This approach provides substantial pain relief, significant functional improvement, and early restoration of daily activities, with a low rate of complications.
Keywords
Osteonecrosis of the femoral head, ONFH, total hip arthroplasty, two-staged bilateral THA
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