Direct Anterior Approach in Lateral Decubitus Position Versus Supine Position for Unilateral Total Hip Arthroplasty:...

Area of Science:

• Orthopedic Surgery
• Surgical Approaches
• Hip Arthroplasty

Background:

• The direct anterior approach (DAA) is a popular surgical technique for total hip arthroplasty.
• Variations in patient positioning, such as lateral decubitus (L-DAA) and supine (S-DAA), may influence surgical outcomes.

Purpose of the Study:

• To compare the clinical efficacy of the lateral decubitus direct anterior approach (L-DAA) versus the supine direct anterior approach (S-DAA) for unilateral total hip arthroplasty.

Main Methods:

• A retrospective study analyzed 89 patients undergoing primary unilateral total hip arthroplasty.
• Data collected included BMI, operation time, blood loss, hemoglobin levels, incision length, hospital stay, Harris scores, VAS scores, radiological evaluation, complications, and leg length discrepancy.

Main Results:

• No significant differences were observed in Harris scores, Hb levels, incision lengths, radiological outcomes, VAS scores, or hospital stay between L-DAA and S-DAA.
• L-DAA demonstrated significantly shorter operation times, less blood loss, and a lower requirement for BMI compared to S-DAA.
• Proximal femoral fractures occurred during surgery (2 in L-DAA, 4 in S-DAA), and leg length discrepancy differed significantly between the groups.

Conclusions:

• The L-DAA approach offers advantages in terms of reduced operation time and blood loss, with easier proximal femur exposure and suitability for lower BMI patients.
• Challenges exist with L-DAA regarding the accurate comparison of lower extremity length compared to the S-DAA.