Two Teams Simultaneous Bilateral Total Hip Arthroplasty via Direct Anterior Approach in an Ordinary Table -A Comparative Study with Matched Pair of Consecutive Bilateral Total Hip Arthroplasty

Abstract

Introduction: The Direct Anterior Approach (DAA) has regained its popularity in total hip arthroplasty (THA). We conducted a pilot study to compare the outcome of two team simultaneous bilateral THA by DDA with a control cohort of patients who underwent single stage bilateral THA by DAA in consecutive fashion. Methods: Group A consisting of patients who underwent two team simultaneous bilateral THA by DAA in ordinary table were matched with a cohort of patients in Group B who underwent consecutive (one after the other) bilateral THA in same sitting by DAA. The parameters compared were Surgical time, Blood loss, Blood Transfusion, Opioid requirement, Length of hospital stay, complication, and the cost. Results: The mean operating time was 99 ± 20.9 minutes in group A as compared with 211.5 ± 27 minutes in group B. This difference was highly significant. The mean intraoperative blood loss in group B (1260 ± 397 ml) was greater than that in group A (930 ± 344 ml). However, this difference was not statistically significant. There was no significant difference between two groups in terms of fall in hemoglobin, blood transfused and opioid requirement. Two team simultaneous THA reduced the duration of operation by an average of 112.5 minutes which equates to approximately Rs.77,287.5 (US$ 1033.77) saved per patient as per our institutional report. Conclusion: Our study suggests that 2 team simultaneous bilateral THA by DAA is equally safe rather less costlier than the consecutive procedure in patients with bilateral hip disease and adequate medical condition.