Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Estudio piloto para evaluar la relación entre el tipo, la ubicación y la profundidad de las lesiones osteocondrales del astrágalo y la inestabilidad del tobillo","authors":"G. Suazo Carrillo ,&nbsp;M. Torralba González de Suso ,&nbsp;R. Díaz Fernández ,&nbsp;F. García-Navas García ,&nbsp;E. Iglesias Durán ,&nbsp;S. Catalán Amigo ,&nbsp;J. Vilá-Rico","doi":"10.1016/j.recot.2025.07.020","DOIUrl":"10.1016/j.recot.2025.07.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Ankle sprains are a common musculoskeletal injury, with 10-30% of cases potentially progressing to chronic lateral ankle instability. In this context, a higher prevalence of talar osteochondral lesions (TOLs) has been observed. This study aims to confirm the association between chronic lateral ankle instability and TOLs, while also evaluating lesion location, severity, and morphology based on the Raikin, ICRS, and Hepple classifications.</div></div><div><h3>Material and methods</h3><div>A multicenter, cross-sectional, observational study was conducted in 7 Spanish hospitals. Patients with MRI-confirmed TOLs were included and subsequently evaluated arthroscopically. Clinical, morphological, and topographic variables were collected. The integrity of the anterior talofibular ligament (ATFL) was assessed through arthroscopy and clinical testing to determine the presence of chronic lateral ankle instability. Lesions were classified using the Hepple, Raikin, and ICRS systems.</div></div><div><h3>Results</h3><div>Among the 42 patients with TOLs, those with recurrent ankle sprains, positive anterior drawer test, and positive talar tilt test showed significantly more severe lesions (p<!--> <!-->&lt;<!--> <!-->0.05). Although ATFL rupture was more frequent in patients with severe lesions, this finding did not reach statistical significance. As a secondary finding, medial osteochondral involvement was more common in female patients (p<!--> <!-->=<!--> <!-->0.006), and patients without ATFL rupture exhibited a significantly larger chondral surface area affected (p<!--> <!-->&lt;<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>This study demonstrates a statistically significant association between chronic lateral ankle instability and TOL severity, particularly in patients with recurrent sprains and positive clinical tests. Interestingly, greater chondral surface involvement was found in patients without ATFL rupture. A higher frequency of medial lesions was observed in women, though no clear correlation with lesion severity was identified.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 105-110"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"¿Es necesaria la realización de pruebas cruzadas preoperatorias a todos los pacientes que van a ser intervenidos de prótesis total de cadera primaria por coxartrosis? Estudio retrospectivo","authors":"A. Santamaría López,&nbsp;B. de la Hera,&nbsp;F. Nehmé Abouzeid,&nbsp;E. Galeote López,&nbsp;A. Mardomingo Alonso,&nbsp;S.J. Sánchez Gutiérrez,&nbsp;R. Rubio Quevedo","doi":"10.1016/j.recot.2025.07.025","DOIUrl":"10.1016/j.recot.2025.07.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Currently, most hospitals systematically request preoperative crossmatching tests for patients undergoing arthroplasty. The aim of this study is to assess whether routine preoperative crossmatch testing (CMT) is necessary for all patients undergoing primary total hip arthroplasty (THA). To this end, we evaluated the transfusion rate, associated clinical risk factors, and the economic impact of routine crossmatch testing.</div></div><div><h3>Material and methods</h3><div>A retrospective study including patients undergoing primary THA for coxarthrosis from 2021 to 2023. Patients with fractures and their complications, as well as prosthetic revisions, were excluded. Epidemiological, clinical, and analytical variables, as well as the cost of routinely performing preoperative CMT were evaluated.</div></div><div><h3>Results</h3><div>A total of 273 patients were included (152 males), with a mean age of 66.9 years [27–89]. Tranexamic acid was administered to 207 patients (75.8%), and surgical drains were used in 133 cases (48.7%). The decision to use tranexamic acid and drains was made by the attending anesthesiologist and surgeon, respectively. The mean length of hospital stay was 2.5 days [1.2–3.7]. All surgeries were performed using a posterolateral approach, and all prostheses implanted were uncemented Polar R3® (Smith &amp; Nephew) components. The mean preoperative hemoglobin level was 14.3<!--> <!-->g/dL [10–19.7], and the postoperative level was 11.1<!--> <!-->g/dL [7.2–14.7]. Blood transfusion was required in 20 patients (7.3%). No urgent or intraoperative transfusions were recorded; all were prescribed postoperatively at the discretion of the attending surgeon. Female sex, the use of surgical drains, and preoperative hemoglobin &lt;<!--> <!-->13<!--> <!-->g/dL were identified as statistically significant risk factors for transfusion (p<!--> <!-->&lt;<!--> <!-->0.05). The estimated cost of routine PPCC was €21,840.</div></div><div><h3>Conclusions</h3><div>The blood transfusion rate following primary THA was less than 10% (7.3%). It seems reasonable to stop routinely performing CMT for every patient undergoing primary THA and to individualize the indication for transfusion based on each specific case.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 117-121"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tratamiento conservador de las fracturas del extremo distal del radio: un arte abandonado","authors":"R. Kaempf ,&nbsp;P. Fischer ,&nbsp;V. Triviño ,&nbsp;D. Falcochio ,&nbsp;D. Fernandez ,&nbsp;P.J. Delgado","doi":"10.1016/j.recot.2025.09.002","DOIUrl":"10.1016/j.recot.2025.09.002","url":null,"abstract":"<div><div>Distal radius fractures are common injuries that every orthopedic surgeon must be able to treat effectively.</div><div>Achieving good outcomes without surgery is complex: it requires proper maneuvers in the emergency department, follow-up visits with cast adjustments or replacements, and follow-up radiographs, often resulting in discomfort for the patient. Additionally, some specialists, especially younger ones, are drawn to the perceived ease and convenience of surgical procedures, which contributes to less familiarity with conservative treatment.</div><div>This update provides a practical guide to the non-operative management of distal radius fractures, from initial care, diagnosis, and reduction techniques to the radiographic and clinical criteria that must be assessed during follow-up to determine whether continued conservative treatment is appropriate.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 154-160"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Uso de WALANT en la corrección del hallux valgus: protocolo anestésico y aspectos técnicos","authors":"M. Ballester ,&nbsp;G. Lúcar ,&nbsp;L. Bello","doi":"10.1016/j.recot.2025.11.031","DOIUrl":"10.1016/j.recot.2025.11.031","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the application of the Wide-Awake Local Anesthesia No Tourniquet –WALANT– technique in hallux valgus surgery, highlighting its advantages in terms of patient comfort and surgical safety.</div></div><div><h3>Methods</h3><div>A descriptive study detailing the steps for administering WALANT anesthesia during hallux valgus correction. Patient selection, local anesthetic preparation, injection technique, and surgical approach were documented. The case of a 65-year-old woman with severe hallux valgus undergoing surgery with the WALANT technique is presented.</div></div><div><h3>Results</h3><div>The patient tolerated the procedure well without requiring sedation or experiencing significant pain. Despite the absence of a tourniquet, the surgery was performed with adequate visibility and hemostatic control. Early mobilization was achieved, and the patient reported a high level of satisfaction. At the 2-week follow-up, wound healing progressed favorably and alignment was satisfactory, with no complications observed.</div></div><div><h3>Conclusion</h3><div>WALANT appears to be a safe and effective alternative for hallux valgus surgery, minimizing the risks associated with general or regional anesthesia while improving the overall patient experience. This report outlines the anesthetic protocol routinely used in our practice, which may serve as a foundation for standardizing its application in forefoot procedures. Further comparative and prospective studies are warranted to assess its clinical and functional outcomes over the medium and long term.</div></div><div><h3>Level of clinical evidence</h3><div>This is a level 4 evidence study as it focuses on the description of a surgical technique based on clinical experience.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T142-T147"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Conservative treatment of distal radius fractures: An abandoned art","authors":"R. Kaempf ,&nbsp;P. Fischer ,&nbsp;V. Triviño ,&nbsp;D. Falcochio ,&nbsp;D. Fernandez ,&nbsp;P.J. Delgado","doi":"10.1016/j.recot.2025.11.018","DOIUrl":"10.1016/j.recot.2025.11.018","url":null,"abstract":"<div><div>Distal radius fractures are common injuries that every orthopaedic surgeon must be able to treat effectively.</div><div>Achieving good outcomes without surgery is complex: it requires proper manoeuvres in the emergency department, follow-up visits with cast adjustments or replacements, and follow-up radiographs, often resulting in discomfort for the patient. Additionally, some specialists, especially younger ones, are drawn to the perceived ease and convenience of surgical procedures, which contributes to less familiarity with conservative treatment.</div><div>This update provides a practical guide to the non-operative management of distal radius fractures, from initial care, diagnosis, and reduction techniques to the radiographic and clinical criteria that must be assessed during follow-up to determine whether continued conservative treatment is appropriate.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T154-T160"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Hemoglobin thresholds: Comments on selective pre-transfusion testing in total hip arthroplasty","authors":"J.H. Núñez ,&nbsp;J. Diego Montenegro ,&nbsp;A. Fraguas Castany","doi":"10.1016/j.recot.2025.11.016","DOIUrl":"10.1016/j.recot.2025.11.016","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T173-T174"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated medial displacement calcaneal osteotomy for treating talo-calcaneal coalition in flat feet-adult population: Is alignment the main problem?","authors":"G. Slullitel ,&nbsp;M. Fa-Binefa ,&nbsp;P. Martínez de Albornoz ,&nbsp;A. Oller Boix ,&nbsp;N. Dopazo González ,&nbsp;A. Fernández Cebrián ,&nbsp;M. Monteagudo","doi":"10.1016/j.recot.2025.05.003","DOIUrl":"10.1016/j.recot.2025.05.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Talo-calcaneal coalition (TCC), presents a significant challenge in adult patients, often associated with pes planus and pes cavus. The aim of this study was to assess the effect of Medial Displacement Calcaneal Osteotomy (MDCO) on TTC.</div></div><div><h3>Materials and methods</h3><div>This study retrospectively analyzed 11 adult patients diagnosed with rigid flat feet caused by TCC, who underwent MDCO without coalition resection. Clinical and radiographic outcomes were assessed using questionnaires (ADL-FAAM, VAS and Likert scale) and imaging (Talar-first Metatarsal angle, Talo-calcaneal angle, both in AP and lateral views, and Talo-navicular Coverage) preoperatively and at one-year follow-up. Postoperative complications, infections or subsequent surgical procedures were also registered during follow up.</div></div><div><h3>Results</h3><div>One year postoperatively, the mean improvement in ADL-FAAM was −49 (SD 15.73), VAS was −6.7 (SD 1.21) and Likert scale −2.6 (SD 0.46). Radiographic analysis post-surgery revealed minimal changes, emphasizing that the substantial clinical benefits were primarily due to the correction of malalignment. A significant correlation was found between talo-calcaneal angles and talo-navicular coverage with postoperative FAAM scores (<em>p</em> <!-->=<!--> <!-->0.011, <em>p</em> <!-->=<!--> <!-->0.047), and talo-calcaneal angles with Likert scores (<em>p</em> <!-->=<!--> <!-->0.05, <em>p</em> <!-->=<!--> <!-->0.008). Patients with more severe preoperative valgus deformities experienced increased improvement.</div></div><div><h3>Conclusion</h3><div>MDCO without coalition resection offers a treatment alternative for adults with TCC-induced flatfoot.</div></div><div><h3>Level of evidence</h3><div>Level IV, retrospective case series.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 91-97"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Is it necessary to perform preoperative cross-matching tests on all patients undergoing primary total hip arthroplasty for coxarthrosis? A retrospective study","authors":"A. Santamaría López,&nbsp;B. de la Hera,&nbsp;F. Nehmé Abouzeid,&nbsp;E. Galeote López,&nbsp;A. Mardomingo Alonso,&nbsp;S.J. Sánchez Gutiérrez,&nbsp;R. Rubio Quevedo","doi":"10.1016/j.recot.2025.11.019","DOIUrl":"10.1016/j.recot.2025.11.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Currently, most hospitals systematically request preoperative crossmatching tests for patients undergoing arthroplasty. The aim of this study is to assess whether routine preoperative crossmatch testing (CMT) is necessary for all patients undergoing primary total hip arthroplasty (THA). To this end, we evaluated the transfusion rate, associated clinical risk factors, and the economic impact of routine crossmatch testing.</div></div><div><h3>Material and methods</h3><div>A retrospective study including patients undergoing primary THA for coxarthrosis from 2021 to 2023. Patients with fractures and their complications, as well as prosthetic revisions, were excluded. Epidemiological, clinical, and analytical variables, as well as the cost of routinely performing preoperative CMT were evaluated.</div></div><div><h3>Results</h3><div>A total of 273 patients were included (152 males), with a mean age of 66.9 years [27–89]. Tranexamic acid was administered to 207 patients (75.8%), and surgical drains were used in 133 cases (48.7%). The decision to use tranexamic acid and drains was made by the attending anaesthesiologist and surgeon, respectively. The mean length of hospital stay was 2.5 days [1.2–3.7]. All surgeries were performed using a posterolateral approach, and all prostheses implanted were uncemented Polar R3® (Smith &amp; Nephew) components. The mean preoperative haemoglobin level was 14.3<!--> <!-->g/dL [10–19.7], and the postoperative level was 11.1<!--> <!-->g/dL [7.2–14.7]. Blood transfusion was required in 20 patients (7.3%). No urgent or intraoperative transfusions were recorded; all were prescribed postoperatively at the discretion of the attending surgeon. Female sex, the use of surgical drains, and preoperative haemoglobin<!--> <!-->&lt;<!--> <!-->13<!--> <!-->g/dL were identified as statistically significant risk factors for transfusion (p<!--> <!-->&lt;<!--> <!-->0.05). The estimated cost of routine PPCC was €21,840.</div></div><div><h3>Conclusions</h3><div>The blood transfusion rate following primary THA was less than 10% (7.3%). It seems reasonable to stop routinely performing CMT for every patient undergoing primary THA and to individualise the indication for transfusion based on each specific case.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T117-T121"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Uncemented bipolar arthroplasty in extracapsular hip fracture in elderly patients","authors":"W.F. Martínez ,&nbsp;E.J. Bochatey ,&nbsp;F.A. Lopreite","doi":"10.1016/j.recot.2025.11.015","DOIUrl":"10.1016/j.recot.2025.11.015","url":null,"abstract":"<div><h3><em>Introduction</em></h3><div>Extracapsular hip fractures in patients over 85 years old represent a therapeutic challenge due to their high vulnerability and risk of complications. This study analyzes the efficacy and safety of bipolar hip arthroplasty with uncemented femoral stems in this population.</div></div><div><h3><em>Materials and methods</em></h3><div>A retrospective study was conducted at three referral hospitals, including 63 patients over 85 years old treated between 2019 and 2023. Clinical, radiological, and functional variables were evaluated with a minimum follow-up of 12 months. Hip function was assessed using the Harris Hip Score (HHS).</div></div><div><h3><em>Results</em></h3><div>The mean age was 86.7 years, with a female predominance (63.5%). The average surgical time was 46<!--> <!-->±<!--> <!-->7<!--> <!-->min, and intraoperative blood loss was 220<!--> <!-->±<!--> <!-->40<!--> <!-->ml. The complication rate was low: 14.2% experienced mild hypotension, 1.6% suffered a periprosthetic fracture, and isolated cases of postoperative hyperglycemia and hypoalbuminemia were promptly resolved. The mean HHS was 79<!--> <!-->±<!--> <!-->8 points at 6 months and 81<!--> <!-->±<!--> <!-->6 points at 12 months. A total of 71.4% of patients regained their pre-injury ambulatory status. No significant prosthetic subsidence or femoral pain was observed.</div></div><div><h3><em>Conclusion</em></h3><div>Bipolar hip arthroplasty with uncemented femoral stems appears to be a safe and effective option for treating extracapsular hip fractures in patients over 85 years old, allowing early rehabilitation and reducing complications associated with cementation and osteosynthesis.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages T136-T141"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Análisis de costes sobre la implantación de prótesis total de cadera primaria bilateral en un hospital público español: un tiempo versus dos tiempos","authors":"E. Galián Muñoz,&nbsp;J.M. López López,&nbsp;M.A. Alacid Hernández,&nbsp;V.T. López Gutiérrez,&nbsp;A. Murcia Asensio","doi":"10.1016/j.recot.2025.08.001","DOIUrl":"10.1016/j.recot.2025.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite growing international evidence supporting the effectiveness, safety, and efficiency of simultaneous bilateral total hip arthroplasty (BTHA), its adoption remains limited in Spain, where the sequential approach (stg-BTHA) is still the most common practice. Assuming that the simultaneous option could offer benefits for both patients and the healthcare system in selected cases, this study aimed to compare the total and categorized healthcare costs between both modalities within a public secondary-level hospital in Spain.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study was conducted including 14 patients who underwent bilateral THA performed by the same surgical team between March 2022 and March 2024. Seven patients underwent simultaneous BTHA and were matched with seven who underwent staged BTHA, based on age, sex, and ASA classification. Clinical, surgical, and economic variables were collected, and costs were categorized as pre-hospitalization, operating room, hospitalization, and postoperative follow-up.</div></div><div><h3>Results</h3><div>No significant differences were found in baseline characteristics between groups. Simultaneous BTHA showed a significantly shorter total operating room time (210<!--> <!-->±<!--> <!-->17<!--> <!-->min vs 240<!--> <!-->±<!--> <!-->21<!--> <!-->min; <em>P</em> <!-->=<!--> <!-->.028) and a shorter hospital stay (1.7<!--> <!-->±<!--> <!-->0.4 days vs 2.4<!--> <!-->±<!--> <!-->0.3 days; <em>P</em> <!-->=<!--> <!-->.04). The mean total cost was 33.5% lower in the simultaneous group (€8,139 vs €10,868), with lower expenses across all categories. No patients required transfusion or experienced complications or readmissions.</div></div><div><h3>Conclusion</h3><div>Simultaneous bilateral THA is more cost-efficient than the staged approach. It requires appropriate patient selection and a specialized multidisciplinary team, representing a safe and efficient option in the context of public healthcare.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"70 2","pages":"Pages 122-128"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147388367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}