Lateral decubitus positioning for hip surgery puts the entire weight of the pelvis onto the greater trochanter — a bony prominence at the lateral femur with very little overlying soft tissue padding. The skin over the trochanter is thin. The subcutaneous fat layer varies widely between patients but is rarely more than a few millimeters thick at this location. After three to four hours of sustained lateral positioning for a total hip replacement, the trochanteric region is at high risk for deep tissue pressure injury — the kind that starts at the bone-muscle interface and works its way outward, invisible at the skin surface until hours or days later. And beyond the soft tissue risk, there’s the nerve protection concern: the sciatic nerve runs posterior to the greater trochanter, and improper lateral positioning can compress it against the underlying bony structures. The AM-TW-018 was designed specifically to prevent both of these outcomes — pressure injury to the trochanteric soft tissue and compression neuropathy of the sciatic nerve — through a contoured geometry that a flat foam wedge simply cannot replicate.
The pad’s 31×32.5cm footprint with a 5cm gel thickness is shaped to cradle the sacrococcygeal region and the lateral pelvis simultaneously, distributing the patient’s weight across the gluteal musculature and flank soft tissue rather than concentrating it on the trochanteric prominence. The defining design feature is the contoured relief channel that runs diagonally across the pad surface. When the patient is positioned laterally, this channel aligns with the greater trochanter so that the bony landmark sits in a zero-pressure zone — suspended in the channel void — while the surrounding gluteal muscles, iliac crest soft tissue, and upper thigh carry the distributed load. The polymer gel formulation is our standard mid-durometer torso-grade material: soft enough to comply with tissue contours and avoid the trampoline effect of a surface that’s too rigid, firm enough not to bottom out under the weight distribution of a 90-kilogram patient in lateral decubitus for four hours. The anti-slip base prevents migration during table tilting and rotational adjustments during the acetabular preparation phase of hip arthroplasty.
The 018 is a specialist pad, not a general lateral support. If you need broad, non-specific torso positioning in lateral decubitus, use the semi-circle (AM-TW-017). If you need dependent limb protection, use the tunnel pad (AM-TW-014). The 018 does one specific thing — offload the greater trochanter and sacrum — and it does it with a contoured geometry designed around the specific anatomy of the lateral pelvis. For an orthopedic center running hip replacements, this pad is not optional equipment.
