Abstract:Objective To systematically analyze and compare the early treatment outcomes of direct anterior approach in lateral decubitus position and posterolateral approach for total hip arthroplasty by Meta-analysis. Methods The relevant literatures documents were retrived from Pubmed, Embase, Cochrane Library, SinoMed, CNKI, Wanfang Data and VIP databases from database establishment to December 2021 by computer. Meta-analysis was performed after screening the literature that met the inclusion criteria and evaluating the risk of bias. Results A total of 814 patients in 10 articles were enrolled. Compared with those in patients treated by posterolateral approach, operation time ［MD=6.42, 95%CI（0.51, 12.33）, P<0.05］, surgical incision ［MD=-2.32,95%CI（-3.25,-1.38）, P<0.01］, intraoperative blood volume ［MD=-68.11, 95%CI（-100.33,-35.90）, P<0.01), postoperative drainage ［MD=-41.29, 95%CI（-62.25,-20.32）, P<0.01］, hospital stay［MD=-2.98, 95%CI（-4.91,-1.04）, P<0.01］, total VAS score within 1 week after surgery ［MD=-0.76, 95%CI（-0.96,-0.55）, P<0.01］ and total incidence of postoperative complications ［RR=0.57, 95%CI（0.34, 0.98）, P<0.05］ statistically decreased in those of patients treated by the direct anterior approach in the lateral decubitus position. Harris hip score was statistically higher in the patients by the direct anterior approach in the lateral decubitus position at 6 months postoperatively ［MD=4.10, 95%CI（2.98, 5.23）, P<0.01). However, there were no significant differences in the postoperative imaging acetabular anteversion and abduction angles between two surgical approaches（P>0.05）. Conclusions In total hip arthroplasty, the direct anterior approach in lateral decubitus position has the advantages of small incision, less intraoperative bleeding and postoperative drainage, shorter hospital stays, less postoperative pain and faster recovery of hip function compared with the posterolateral approach, but the operative time is longer.