Abstract

While accumulating data on the direct anterior approach to total hip arthroplasty (THA) have demonstrated clinical benefit and durable results, there is little data that exists on patient-centered outcomes and satisfaction when comparing simultaneous bilateral procedures with staged arthroplasty. The aim of this study was to determine whether simultaneous bilateral THA and staged arthroplasty result in equivalent early (1) patient-centered outcomes and patient satisfaction; while maintaining acceptable rates of (2) objective clinical outcome scores, (2) complication rates; and (3) radiographic results. In retrospective review, 41 patients who underwent bilateral one-stage THA were compared to 44 patients who underwent staged bilateral THA during the same time period. The minimum clinical follow up was two years. Generic (EQ-VAS and EuroQoL- 5D index) and condition-specific (Oxford Hip Score) instruments were used to assess patient-reported outcomes. Other variables included length of hospital stay (LOS), operative and anesthetic times, blood loss, intra- and post-operative (local and systemic) complications, and radiographic analysis. No significant differences between the two groups were found for patient-reported outcomes, complications, or radiographic assessment. The simultaneous THA group had shorter LOS and operative and anesthetic times, as well as less blood loss. Simultaneous and staged bilateral THA using the direct anterior approach offer equivalent short-term patient-reported outcomes, with acceptable safety and efficacy profiles. Simultaneous arthroplasty may offer superior benefit with respect to length of stay, operative time, and blood loss. These results may inform the patient-surgeon discussion regarding simultaneous versus staged THA.