Functional Outcomes, Complications, and Survivorship After Simultaneous Bilateral Total Hip Arthroplasty: A Retrospective Cohort Study with a Median Follow-up of 4.6 Years.

Abstract

Simultaneous bilateral total hip arthroplasty (sbTHA) offers the advantages of single-stage treatment for end-stage bilateral hip disease, but raises concerns about increased perioperative risk and implant survivorship. This study aimed to evaluate functional outcomes, complications, and implant survivorship following sbTHA under contemporary perioperative protocols with a median follow-up of 4.6 years. We conducted a retrospective study of 92 patients (184 hips) who underwent elective sbTHA at a single institution between 2008 and 2019. Their median age was 60 years (interquartile range [IQR], 52 to 68). There were 48 men (52.2%), and the median follow-up was 4.6 years (IQR, 3.2 to 7.0). The primary outcomes included functional scores, complications, readmissions, and implant survivorship. There was a significant improvement in functional scores and pain evaluation at final follow-up (P < 0.001). The overall complication rate was 6.5% (12 of 184 hips). Transfusion was required in 6.5% of patients (six of 92). When revision surgery was used as the endpoint, the implant survivorship was 95.7%. The sbTHA provides excellent functional outcomes and survivorship at a median follow-up of 4.6 years, with an acceptable complication profile in carefully selected patients managed with modern perioperative and blood management protocols.