Safety of Single-Stage Bilateral Direct Anterior Approach Total Hip Arthroplasty Performed in All Eligible Patients at a Honolulu Hospital.

Total hip arthroplasty (THA) is a commonly performed surgery, with candidates often requiring bilateral replacement. Simultaneous, single-stage bilateral THA offers several advantages and the direct anterior approach (DAA) for THA is well-suited for this procedure. In Hawai'i, single-stage bilateral DAA THA has yet to be adopted as a primary practice, and currently, there is limited research on patient outcomes following single-stage bilateral DAA THA in heterogeneous patient populations. In this study, we present our experience regarding intraoperative and 90-day complication rates encountered in a consecutive, all-inclusive cohort of single-stage bilateral DAA THA performed at the Straub Medical Center in Honolulu, Hawai'i, from January 2016 to May 2018. A total of 99 patients were included with a mean age of 64.7 ± 10.1 (mean ± standard deviation) years. The sample consisted of 43 (43.4%) males. Mean BMI was 27.0 ± 5.3 kg/m. The racial composition consisted of 50 (50.5%) Asian, 37 (37.4%) Caucasian, 8 (8.1%) Hawaiian/Pacific Islander, 1 (1.0%) African-American, 3 (3.0%) undisclosed. Mean operating time was 180 ± 23 minutes. Mean intraoperative blood loss was 386 ± 75 mL, and 11 (11.1%) patients received a postoperative allogenic blood transfusion. There were no major intraoperative complications. The only major local complication observed was one patient who developed high-grade heterotopic ossification requiring surgery. No major systemic complications occurred. The overall complication rate was 0.5%. In conclusion, we demonstrate that single-stage bilateral DAA THA is a safe option for the treatment of bilateral hip pathology in a wide spectrum of patients.