Papalia Giuseppe Francesco, Zampogna Biagio, Albo Erika, Torre Guglielmo, Villari Eleonora, Papalia Rocco, Denaro Vincenzo
Department of Orthopaedic and Trauma Surgery Campus Bio-Medico University of Rome.
Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Orthop Rev (Pavia). 2023 Apr 11;15:74116. doi: 10.52965/001c.74116. eCollection 2023.
Total Hip Arthroplasty (THA) may be performed through various approaches; however, depending on the surgical position of the patient, the superiority of lateral or supine position is still debated. The aim of this systematic review and meta-analysis was to compare the supine versus lateral position in THA in terms of intraoperative and postoperative outcomes and component placement. The systematic literature search was performed by the use of Cochrane Central, Pub-Med-Medline, and Google Scholar in order to select studies that evaluated clinical outcomes and the outliers of cup alignment for inclination and anteversion between supine and lateral position for hip arthroplasty. Finally, 9 articles were included in this review. The meta-analysis showed no significant differences between the two groups for clinical outcomes, unless for blood loss and VAS (respectively p = 0.05 and p = 0.004 in favour of lateral decubitus). Regarding the number of outliers, the supine decubitus showed significant differences only for the cup anteversion (p = 0.01). However, more prospective studies with a longer follow-up that analyze both clinical and radiological parameters are needed to assess the superiority of supine or lateral patient position for total hip arthroplasty.
全髋关节置换术（THA）可通过多种入路进行；然而，根据患者的手术体位，侧卧位或仰卧位的优势仍存在争议。本系统评价和荟萃分析的目的是比较THA中仰卧位和侧卧位在术中和术后结果以及假体植入方面的差异。通过使用Cochrane中心、PubMed-Medline和谷歌学术进行系统的文献检索，以选择评估临床结果以及髋关节置换术中仰卧位和侧卧位之间髋臼外展角和前倾角的髋臼对线异常情况的研究。最终，本评价纳入了9篇文章。荟萃分析表明，两组在临床结果方面无显著差异，但失血情况和视觉模拟评分（VAS）除外（分别为p = 0.05和p = 0.004，支持侧卧位）。关于异常值的数量，仰卧位仅在髋臼前倾角方面存在显著差异（p = 0.01）。然而，需要更多具有更长随访时间且能同时分析临床和放射学参数的前瞻性研究，以评估全髋关节置换术中仰卧位或侧卧位患者体位的优势。
