A retrospective analysis of the merits and challenges associated with simultaneous bilateral THA using the direct anterior approach.

Journal Article (Journal Article)

INTRODUCTION: 15%-20% of patients presenting for total hip arthroplasty (THA) have bilateral disease. While simultaneous bilateral THA is of interest to patients and surgeons, debate persists regarding its merits. The majority of previous reports on simultaneous bilateral THA involve patients in the lateral decubitus position, which require repositioning, prepping and draping, and exposure of a fresh wound to pressure and manipulation for the contralateral THA. The purpose of this study was to compare complications, component position, and financial parameters for simultaneous versus staged bilateral THAs using the direct anterior approach (DAA). METHODS: Medical records were reviewed for patient demographics, medical history, operative time, estimated blood loss (EBL), change in hemoglobin, transfusion, tranexamic acid (TXA) use, length of stay (LOS), discharge disposition, leg length discrepancy, acetabular cup position, and perioperative complications. Cost and reimbursement data were analysed. RESULTS: 44 patients were included in the sequential group and fifteen patients in the simultaneous group. Operative time, EBL, hemoglobin drop, transfusion rate, and LOS were significantly increased for simultaneous group. There was no significant difference in component position, complications, or readmissions between groups. Profit per hip was significantly higher for the simultaneous group. DISCUSSION: While simultaneous DAA THA presents challenges, our results suggest that simultaneous DAA THA may add value to the healthcare system without resulting in increased complications compared to sequential hip arthroplasty.

Full Text

Duke Authors

Cited Authors

  • Brown, ML; Plate, JF; Holst, DC; Bracey, DN; Bullock, MW; Lang, JE

Published Date

  • March 31, 2017

Published In

Volume / Issue

  • 27 / 2

Start / End Page

  • 169 - 174

PubMed ID

  • 27886354

Electronic International Standard Serial Number (EISSN)

  • 1724-6067

Digital Object Identifier (DOI)

  • 10.5301/hipint.5000449


  • eng

Conference Location

  • United States