DIRECT ANTERIOR APPROACH FOR TOTAL HIP ARTHROPLASTY IN LATERAL DECUBITUS

Objective: The presented retrospective study compares the early efficacies with lateral decubitus direct anterior approach (DAA) versus posterolateral approach(PLA) total hip arthroplasty. Methods: The study included 84 arthroplasties in 84 patients treated with lateral decubitus direct anterior approach or posterolateral approach total hip arthroplasty from October 2017 to October 2018. Data regarding the muscle damage marker CK(creatine kinase), the inflammatory markers C-reactive protein(CRP), IL-6(interleukin 6) and erythrocyte sedimentation rate(ESR), intraoperative blood loss, incision length, operative time, postoperative hospital stay, visual analogue scale(VAS) pain score, Harris hip score, complications, radiological data were compared. Results: Lateral decubitus DAA was associated with lower levels of the muscle damage marker CK, the inflammatory markers C-reactive protein, IL-6 and erythrocyte sedimentation rate for postoperative days 1-4(P<0.05). Lateral decubitus DAA was associated with a shorter incision, shorter postoperative hospital stay, more intraoperative blood loss and longer operative time(P<0.05), as well as significantly lower visual analogue scale(VAS) pain score on all 3 postoperative days(P<0.05 ). Lateral decubitus DAA was associated with a significantly higher Harris hip score(P<0.05). Conclusion: Lateral decubitus DAA can offer rapid functional recovery with less muscle damage, shorter incision, shorter postoperative hospital stay, greater pain relief for patients, which is more in line with the concept of minimally invasive and is thus worthy of our promotion.