Blood loss in total hip arthroplasty. Lateral position combined with preservation of the capsule versus supine position combined with capsulectomy

The intraoperative blood loss of 40 uncomplicated primary total hip arthroplasties was studied in a retrospective, matched pair analysis. Half of them were implanted in the supine position after complete excision of the capsule and the other half in the lateral position with preservation of the capsule. The patients were matched for mono- or bilateral procedure. Only one surgeon carried out the operations using the same operative technique and identical prosthesis in both groups. The intraoperative blood loss associated with the lateral position and preservation of the capsule averaged 830 ml and was significantly lower (P = 0.01) than 1165 ml with the supine position and complete capsulectomy. Thus, the intraoperative blood loss can be significantly reduced in primary total hip arthroplasty by choosing the lateral position and preserving the capsule.