INTRODUCTION Although the advantages of total hip arthroplasty (THA) using the direct anterior approach (DAA) have been well documented, DAA in the supine position is limited by the difficulty in exposing the acetabulum and femur, which may result in implant malpositioning and intra-operative complications. Recent studies have reported that DAA-THA in the lateral position can achieve satisfactory clinical and radiographic outcomes. The aim of this study was to investigate the difference in implant alignment between two patient cohorts that underwent primary THA by DAA and the traditional posterolateral approach (PLA) in the lateral position. METHODS A total of 208 THAs (110 using DAA and 98 using PLA) were retrospectively analyzed. RESULTS The cup anteversion angle was closer to the target anteversion angle, and the accuracy of cup orientation was superior in the DAA group. A total of 82 (74.5%) DAA-THA and 56 (57.1%) PLA-THA cases showed successful inclination and anteversion angles (p = 0.008) of the implant. In addition, 90 (81.8%) DAA-THA and 67 (68.4%) PLA-THA cases had successful anteversion angle (p = 0.024). There was no significant difference between the two groups in terms of successful inclination angle (98 vs. 81, p = 0.181), as well as in the stem alignment in both coronal and sagittal planes. CONCLUSION THA using DAA in the lateral position can achieve superior cup orientation compared to PLA while maintaining the stem alignment.

中文翻译：

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侧卧位直接前入路在全髋关节置换术中实现了优越的杯定向：两个连续系列的放射学比较研究。


引言 虽然使用直接前路 (DAA) 的全髋关节置换术 (THA) 的优点已得到充分证明，但仰卧位的 DAA 因难以暴露髋臼和股骨而受到限制，这可能导致植入物错位和内固定。手术并发症。最近的研究表明，侧卧位 DAA-THA 可以获得满意的临床和影像学结果。本研究的目的是调查接受 DAA 初次 THA 和侧卧位传统后外侧入路 (PLA) 的两个患者队列之间种植体对准的差异。方法 对 208 例 THA（110 例使用 DAA，98 例使用 PLA）进行回顾性分析。结果DAA组的罩杯前倾角更接近目标前倾角，罩杯定位的准确性也优于DAA组。总共 82 例 (74.5%) DAA-THA 和 56 例 (57.1%) PLA-THA 病例显示种植体成功倾斜和前倾角 (p = 0.008)。此外，90 例 (81.8%) DAA-THA 和 67 例 (68.4%) PLA-THA 病例获得了成功的前倾角 (p = 0.024)。两组之间在成功倾斜角度（98 vs. 81，p = 0.181）以及冠状面和矢状面的柄对齐方面没有显着差异。结论 与 PLA 相比，在侧位使用 DAA 的 THA 可以实现优于 PLA 的杯定向，同时保持柄对齐。