title: Comparison of patient satisfaction after unilateral or simultaneous bilateral total hip arthroplasty through a direct anterior approach: Evaluation using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire.
abstract: BACKGROUND
  The aim of this study was to compare patients' perception of treatment outcome after unilateral or simultaneous total hip arthroplasty (THA) using the newly developed Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ).
  
  
  METHODS
  This study included 429 patients treated with primary THA using a direct anterior approach, namely 304 cases of in the unilateral THA (58 males and 246 females; mean age, 62.3 years) and 125 cases of in the simultaneous bilateral THA (24 males and 101 females; mean age, 58.3 years). Items for evaluation included clinical outcomes and all four aspects of the JHEQ score, namely visual analog scale (VAS), pain, movement, and mental status.
  
  
  RESULTS
  The mean operative time per hip was 51.3 ± 19.4 min (range, 22-180 min) in unilateral group and 46.2 ± 15.1 min (range, 26-106 min) in simultaneous bilateral group. The mean operative blood loss per hip was 421.2 ml ± 232.1 ml (range, 70-1300 ml) in unilateral group and 200.8 ± 149.8 ml (range, 30-1040 ml) in simultaneous bilateral group. The total JHEQ score (pain/motion/mental status) improved from 26.5 ± 13.6 (preoperative, 10.1/6.8/9.6) to 69.4 ± 14.8 (1 year postoperatively, 25.1/20.5/23.8) in unilateral group and from 21.0 ± 8.2 (preoperative, 11.9/2.3/6.9) to 74.9 ± 9.5 (1 year postoperatively, 27.2/22.6/25.0) in simultaneous bilateral group. These results demonstrated a significant improvement before and after surgery for patients in both groups. There were not major complications such as dislocation, bone fracture, nerve palsy or symptomatic pulmonary embolism were observed.
  
  
  CONCLUSIONS
  In this study, we observed greater improvement in JHEQ in patients treated with bilateral simultaneous THA than in those treated with unilateral THA. These findings demonstrated that bilateral simultaneous THA was related to high patient satisfaction as well as high safety.
authors.affiliation: Funabashi Orthopedic Hospital, Japan. Electronic address: hiropon10141696@yahoo.co.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshii
authors.affiliation: Funabashi Orthopedic Hospital, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Oinuma
authors.affiliation: Funabashi Orthopedic Hospital, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Tamaki
authors.affiliation: Funabashi Orthopedic Hospital, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Funabashi Orthopedic Hospital, Japan.
authors.forename: Ryutaku
authors.initials: R
authors.lastname: Kaneyama
authors.affiliation: Funabashi Orthopedic Hospital, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shiratsuchi
mesh_terms: D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011475:Prosthesis Failure; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012189:Retrospective Studies; D012737:Sex Factors; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D016896:Treatment Outcome