Simultaneous Versus Staged Bilateral Total Hip Arthroplasty Via A Lateral Approach

INTRODUCTION: Studies comparing simultaneous bilateral total hip arthroplasty (simBTHA) and staged bilateral total hip arthroplasty (stgBTHA) using a lateral approach are rare. The aim of this study was to compare staged and simultaneous total hip arthroplasty surgeries performed with the lateral approach.
METHODS: In this study, 53 BTHA patients (106 cases) treated in our clinic between 2015 and 2022 were included. Of these patients, 21 received simBTHA and 32 received stgBTHA. The patients were divided into two groups: simBTHA and stgBTHA. The groups were evaluated in terms of periprosthetic fracture, blood transfusion rate, gender, age, Body Mass Index (BMI), ASA scores, operation time, and hospital stay. Functional outcomes and major complication rates were compared between the groups. The Harris Hip Score was used to assess functional outcomes.
RESULTS: Blood transfusion rates and hospital stay times were higher in the simBTHA group than in the stgBTHA group. Periprosthetic infection, pulmonary embolism, hematoma, mortality, and >10 mm leg length discrepancy were not found in either group. Harris scores of the simBTHA group and stgBTHA group were 94.3±6.5 and 92.3±5.9, respectively (p=0.203). The major complication observed was perioperative periprosthetic fracture (PPF) in 4 (7.6%) cases. The PPF rate was higher in the simBTHA group (14.2%) compared to the stgBTHA group (3.1%); however, this difference was not statistically significant (p=0.289). The blood transfusion rate was significantly higher in the simBTHA group than in the stgBTHA group (p=0.010).
DISCUSSION AND CONCLUSION: The main finding of this study is that simBTHA with a lateral approach is associated with increased blood transfusion requirements and periprosthetic fracture complications. Therefore, simultaneous BTHA via the lateral approach may not be preferable, especially in patients with increased perioperative risk.