Background: Patients who undergo total hip arthroplasty (THA) oftentimes have severe osteoarthritis in both hips and may consider staged or simultaneous bilateral THA (bTHA). The goal of this study was to compare the total workdays missed following staged and simultaneous bTHA performed via either postero-lateral (PA) or direct anterior approach (DAA).
Methods: Patients who were (1) employed, (2) underwent a staged (within 12 months) or simultaneous bTHA at our institution between February 1, 2016, and December 31, 2021, (3) completed a return-to-work questionnaire, and (4) had the same surgical approach for both THAs were included. The primary outcome of interest was the total days of work missed.
Results: We identified 78 employed patients who had undergone staged bTHA (62 PA, 16 DAA) and 76 patients (44 PA, 32 DAA) who underwent simultaneous bTHA, and had completed the return-to-work questionnaire. Simultaneous bTHA patients missed an average of 25.6 days of work (SD: 14.3 days) compared to staged bTHA patients, who missed an average of 36.9 days of work (SD: 23.4) when combining days missed from both operations (P < 0.001). In multivariate mixed regression analysis adjusted for sex, age, body mass index, American Society of Anesthesiologists status, type of work, and surgical approach, the staged bTHA group missed a mean of 8.2 more days of work (SD: 3.3) compared to the simultaneous bTHA group (95% confidence interval: 1.8 to 14.7, P = 0.013).
Conclusions: Employed patients who underwent simultaneous bTHA missed an average of 8.2 fewer days of work compared to those who were treated with staged bTHA. These findings may help surgeons counsel their employed patients who have bilateral hip osteoarthritis and are considering surgical treatment.
Level of evidence: IV, retrospective cohort study.
Keywords: bTHA; bilateral total hip arthroplasty; return to work; simultaneous; staged.
Published by Elsevier Inc.