title: Perioperative complication rate of one-stage bilateral total hip arthroplasty using the direct anterior approach.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Funabashi Orthopedic Hospital, Japan. Electronic address: ttamaki@fff.or.jp.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Tamaki
authors.affiliation: Funabashi Orthopedic Hospital, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Oinuma
authors.affiliation: Funabashi Orthopedic Hospital, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Funabashi Orthopedic Hospital, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Higashi
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*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D056888:Patient Positioning; D019990:Perioperative Care / Q000379:methods; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome