Simultaneous versus Staged Bilateral Direct Anterior Total Hip Arthroplasty: Are Early Patient-centered Outcomes Equivalent?

Background.  Sparse data exists on patient-centered outcomes and satisfaction when comparing simultaneous bilateral direct anterior THA procedures with staged arthroplasty.  Questions. 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. Methods.  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, operative time, intra- and post-operative complications, and radiographic analysis. Results. No significant differences between the two groups were found for patient-reported outcomes, complications, or radiographic assessment.  Conclusions. Simultaneous and staged bilateral THA using the direct anterior approach offer equivalent short-term patient-reported outcomes, with acceptable safety and efficacy profiles.  These results may inform the patient-surgeon discussion regarding simultaneous versus staged THA.