Abstract
Background: Direct anterior approach (DAA）for total hip arthroplasty (THA）could be performed either in the lateral decubitus position or supine position. However, there is an obvious absence of literature regarding the differences, which position may be more conducive to recovery, technically more demanding, associated with component malposition or more complications. Methods: From Jan.1st, 2020 to oct.1st, 2020, 45 patients were recruited for primary unilateral THA using the DAA. In total, 27 patients (60%) underwent THAs using the DAA in the supine position, and 18 patients (40%) in the lateral decubitus position. All surgeries were performed by a high-volume surgeon. Technical information, clinical and radiographic outcomes, SF-12 and patient-reported outcomes such as WOMAC were evaluated. All the date were tested with Generalized Linear Mixed Models Analysis, GLM Repeated Measurement Analysis, Independent samples t-test or Pearson’s chi-square test.Results: There were no differences in Population characteristics before surgery. The operation time, length of stay and blood loss in the LP group and the SP group were no differences. The prosthesis of the two groups were in a good position. pre-operative and the first and third day after the surgery of CK-MB and Hb,pre-operative and the last follow-up of HSS,WOMAC,UCLA,VAS,SF-12,and pre-operation and post-operation of Offset,FA and LLD, all the above indicators show no significant difference. And the incidence of complications in the lateral position was lower than that in the supine position.Conclusion: Both THA via DAA in the lateral decubitus position and in the supine position produced excellent clinical outcomes. From the perspective of the occurrence of complications, we are more inclined to use the lateral position.
Direct Anterior Approach for Total Hip Arthroplasty in the Lateral Decubitus Position Versus Supine Position: A Random Clinical Trial
