Bilateral Total Hip Arthroplasty: Outcomes of Staged versus Simultaneous Procedures Performed Using an Anterior-Based Muscle-Sparing Approach
Abstract
INTRODUCTION: The incidence of total hip arthroplasty (THA) in the United States continues to increase due to its ability to markedly improve patients' quality of life in a reproducible manner. However, there remains debate surrounding the efficacy and surgical outcomes of simultaneous bilateral THA compared to staged bilateral procedures. This study investigated and compared the perioperative and postoperative outcomes of simultaneous (SI-THA) and staged (ST-THA) bilateral THA procedures using an anterior-based muscle-sparing (ABMS) approach. METHODS: This retrospective case control study evaluated perioperative and postoperative outcomes from primary bilateral SI-THA or ST-THA (within 365 days) performed with the ABMS approach by 3 surgeons at a single institution between January 2013 and August 2020. The institution's electronic health record was used for data collection. There were a total of 226 patients (113 in each cohort) who were matched based on age, sex, body mass index, and a comorbidity score. RESULTS: Compared to the ST-THA group, the SI-THA had shorter anesthesia duration (P<0.001) and shorter length of stay (P<0.001), but longer length of surgery (P=0.002). There was no statistical significance between groups in blood transfusion rates, discharge dispositions, ED visits, hospital readmissions, or postoperative complications within one year. CONCLUSIONS: The results of this study demonstrate that SI-THA and ST-THA yield comparable results using the ABMS approach. Our perioperative and postoperative results suggest low rates of complications, ED visits, readmissions, and high rates of patient satisfaction scores. Therefore, both SI-THA and ST-THA can be considered by experienced surgeons as treatment for advanced bilateral hip arthritis.