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There were no clinically relevant differences in early postoperative mortality between simultaneous and staged bilateral surgery in healthy patients. Advanced age, RA, a high ASA class and male sex increased the risk of death within 90 days. There may be an issue with enhanced risk of implant revision in patients with simultaneous bilateral THA that needs to be explored further…

…THA is considered a safe procedure. The early postoperative mortality is low and has decreased over the last years, and a systematic review concluded that the average 90-day mortality after THA was 0.7% . Simultaneous bilateral surgery is also described as feasible and safe. Excellent functional results after simultaneous bilateral surgery were already reported by Jaffe and Charnley in 1971  and early postoperative mortality after this procedure is reported to be low. 90-day mortalities between 0.14 and 0.16%  and a peri-operative mortality (without specification of the exact time frame) of 0.31% vs. 0.18% when compared with unilateral surgery  are reported. Putative benefits of simultaneous bilateral THA include a single hospital stay, a shorter rehabilitation period, higher patient satisfaction, and lower costs per patient .