Total hip arthroplasty in lateral decubitus position based on direct anterior minimum invasive surgery

Ye Shan-shan; Gao Hui; Zhang Yu; He Chun-lei

doi:10.3969/j.issn.2095-4344.0157

Abstract：BACKGROUND: Direct anterior minimum invasive surgery (DAMIS) total hip arthroplasty has been considered as the total hip arthroplasty that is most consistent with the minimally invasive standards. In theory, there is a low incidence of complications in the DAMIS total hip arthroplasty. However, because minimally invasive surgery demands high surgery skills, the incidence rate of complications is high in the early period of its learning curve. Lateral decubitus position DAMIS was considered to provide a better perspective, so that, the incidence of surgical complications may be reduced. OBJECTIVE: To explore the feasibility of lateral decubitus position DAMIS for total hip arthroplasty. METHODS: Totally 62 cases from the Department of Orthopedics, First Affiliated Hospital of Gannan Medical University between April 2013 and April 2016 were retrospectively analyzed, and randomly assigned to two groups: lateral decubitus position group (n=31) and supine position group (n=31). Incision length, operative time, intraoperative blood loss, acetabular cup angle, hospital stay, Harris scores, Visual Analogue Scale score, and SF-36 score were compared between the two groups. Complications at postoperative 1 year were recorded. RESULTS AND CONCLUSION: (1) Operative time was longer and intraoperative blood loss was more in the lateral decubitus position group than in the supine position group (P < 0.05). There were no statistically significant differences in incision length and hospital stay between the two groups (P > 0.05). (2) There were no significant differences in the incidence of postoperative complications between the two groups (P >0.05). (3) There were no significant differences in the anteversion and abduction angles of acetabular cup between the two groups (P > 0.05). (4) There were no significant differences in Harris hip score, Visual Analogue Scale score, and SF-36 the quality of life scores between the two groups before surgery and 1 year after surgery (P > 0.05). (5) In conclusion, DAMIS total hip arthroplasty can abandon special traction bed when patients are in lateral decubitus position. The short-term effects are the same with supine DAMIS total hip arthroplasty.