Direct Anterior Versus Posterior Simultaneous Bilateral Total Hip Arthroplasties: No Major Differences at 90 Days

We conducted a study to compare 90-day outcomes of patients who underwent simultaneous bilateral total hip arthroplasties (THAs) through the direct anterior (DA) approach (n = 19 patients) or the posterior approach (n = 21) over a 2-year period (2012-2014). Compared with patients in the posterior group, patients in the DA group had longer operative times (153 vs 106 min; P < .001) and longer anesthesia times (257 vs 221 min; P = .007) but were more likely to be discharged home (100.0% vs 71.4%; P = .02). DA THA was associated with a larger amount of intraoperative blood salvage (1.4 vs 0.5 unit; P = .003), but the groups had similar postoperative hemoglobin levels (10.6 vs 10.3 g/dL; P = .49) and allogenic blood transfusion rates (0% vs 14.3%; P = .23). Simultaneous bilateral THAs can be safely performed through either the DA approach or the posterior approach. Outcomes at 90 days are similar.