Effect of Patient Positioning with Single Surgical Approach in Total Hip Arthroplasty

Objective: The aim of this study was to evaluate the effect of patient position during surgery using direct lateral approach for total hip arthroplasty. Methods: Randomized controlled prospective study of patients was done. Total sixty patients were included in the study, of the 60 patients (33 males, 27 females), the mean age was 48.9 +/- 12.34 (range 29 to 69) years. Patients were randomized in two groups 'S' & 'L' by lottery method. Study was conducted from January 2018 to June 2019. Outcome parameters were compared in terms of size of incision, timing of surgery, postoperative transfusion, acetabular component inclination and femoral stem position. Harris hip score was used pre and postoperatively and up to 1 year. Results: The L group 30 patients (17males, 13 females) with a mean age of 47.3 +/- 12.98 (range, 20 to 86) years. The S group included 30 patients (16 males, 14 females) with a mean age of 50.63 +/- 11.63 (range, 23 to 82) years. Incision length was comparatively smaller in L group, surgery time was shorter is S group, however blood transfusion required post operatively was higher in S group as compared to L group requiring 0.5 pint on an average. In terms of cup inclination (p = 0.001) and femoral stem alignment (p < 0.001) significant p value was noted with better alignment of cup and stem in L group were found. Harris hip score was comparable in both the groups preoperatively (p = 0.087) and 1 year post operatively (p = 0.572). Conclusion: In this study, we conclude that lateral decubitus position has advantages of smaller incision size, better implant position and less blood loss. However, harris hip score was better and almost same in both the groups at one year follow up.