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Updated: Mar 18, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Perioperative complication rate of one-stage bilateral total hip arthroplasty using the direct anterior approach
Tatsuya Tamaki1, Kazuhiro Oinuma1, Yoko Miura1
1Funabashi Orthopedic Hospital, Japan.
Background:
To date, details of the surgical and clinical outcomes of one-stage bilateral total hip arthroplasty using the direct anterior approach have not been widely available. The purpose of this study was to report the perioperative blood management and investigate the perioperative complication rate of one-stage bilateral total hip arthroplasty using the direct anterior approach.
Methods:
We retrospectively assessed 325 consecutive patients (650 hips) who underwent one-stage bilateral total hip arthroplasty through the direct anterior approach.
Results:
The mean intraoperative blood loss and operating time were 412 g and 87.2 min, respectively. One patient (0.3%) required postoperative transfusions of allogeneic blood. Post-operative local major complications occurred in 6 hips (0.9%) in 6 patients, including 2 (0.3%) dislocations, 2 (0.3%) early cup migrations, and 2 (0.3%) peri-prosthetic femoral fractures. No systemic major complication was detected.
Conclusion:
We conclude that the low rate of systemic complications in this study was due to supine positioning and the minimally invasive aspect of the direct anterior approach, and that the approach is therefore a reasonable choice for one-stage bilateral THA.

