Alexis® Orthopedic Protector Provides Wound Protection and Aids in Hypertrophic Scar Prevention in Total Hip Arthroplasty.

Abstract

Total hip arthroplasty (THA) is one of the most widely performed orthopedic surgeries. Techniques for small skin incisions and preservation of muscles and tendons have been developed. However, avoiding skin complications and muscle damage due to forced deployment and surgical manipulation is challenging. This study aimed to investigate whether the use of Alexis® Orthopedic Protector (Applied Medical Resources Corp., Rancho Santa Margarita, CA, USA) affects postoperative outcomes. This was a retrospective cohort study including 118 patients who underwent primary THA by the same surgeon at our single institution between March 2021 and March 2023. Protectors were used alternately for each operation. Fifty-nine patients were in the protector-using group (P group), and 59 were in the nonprotector-using group (N group), with comparisons made between groups. Protectors were placed under the fascia in all patients. Preoperative blood tests showed no difference in renal and hepatic function between the two groups. No differences in postoperative C-reactive protein (CRP) and creatine kinase (CK) values or in the Japanese Orthopedic Association Hip Disease Evaluation Questionnaire (JHEQ) and Numerical Rating Scale (NRS) scores were observed. Postoperative redness was significantly higher in the N group than in the P group (49.2% vs. 7%). The percentage of hypertrophic scars at three months postoperatively was 18.6% in the N group and 7% in the P group. Furthermore, the Japan Scar Workshop Scar Scale (JSS) indicated that hypertrophic scars were significantly worse in the N group than in the P group (p = 0.0012). Alexis® Orthopedic Protectors can not only provide short-term wound protection but also reduce the rate and degree of hypertrophic scarring.