JOA - 2026-06-08 - Journal Article
Functional Outcomes, Complications, and Survivorship After Simultaneous Bilateral Total Hip Arthroplasty: A Retrospective Cohort Study with a Median Follow-up of 4.6 Years.
Diaz Dilernia F, Vasarhelyi E, Lanting B, Naudie D, McCalden R, MacDonald S, Howard J
Topics
Key Takeaway
Simultaneous bilateral THA in 92 carefully selected patients achieved 95.7% implant survivorship at median 4.6-year follow-up with a 6.5% overall hip-level complication rate.
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Summary
This single-institution retrospective study evaluated functional outcomes, complications, and survivorship in 92 patients undergoing elective sbTHA between 2008 and 2019 under contemporary perioperative protocols. Overall hip-level complication rate was 6.5% (12/184 hips), transfusion was required in 6.5% of patients (6/92), and implant survivorship with revision as endpoint was 95.7% at median 4.6 years. Functional scores and pain measures improved significantly at final follow-up (P<0.001).
Key Limitation
Absence of a concurrent staged bilateral or unilateral THA control group prevents determination of whether sbTHA confers excess perioperative risk or cost relative to alternatives.
Original Abstract
BACKGROUND
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.
METHODS
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.
RESULTS
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%.
CONCLUSIONS
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.