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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Ramadanov, Nikolai Bueschges, Simon Liu, Kuiliang Lazaru, Philip Marintschev, Ivan |
| Abstract | Background Two minimally invasive approaches showed some advantages in outcomes compared to conventional approaches (CAs)—the direct anterior approach (DAA) and the supercapsular percutaneously assisted approach in THA (SuperPATH). To the best of our knowledge, DAA and SuperPATH have never been compared, neither in clinical studies, nor in a meta-analysis. To conduct a systematic review and network meta-analysis of randomized controlled trials comparing short-term outcomes of DAA and SuperPATH in total hip joint arthroplasty (THA). Methods A systematic literature search up to May 2020 was performed to identify randomized controlled trials (RCTs) comparing SuperPATH with CAs and DAA with CAs in THA. We measured surgical, functional, and radiological outcomes. A network meta-analysis, using frequentist methods, was performed to assess treatment effects between DAA and SuperPATH. Information was borrowed from the above-mentioned RCTs, using the CA group as a common comparator. Results A total of 16 RCTs involving 1392 patients met the inclusion criteria, three trials with a level I evidence, 13 trials with a level II evidence. The overall network meta-analysis showed that SuperPATH reduced operation time (fixed effect model: MD = 12.8, 95% CI 9.9 to 15.7), incision length (fixed effect model: MD = 4.3, 95% CI 4.0 to 4.5; random effect model: MD = 4.3, 95% CI 0.2 to 8.4), intraoperative blood loss (fixed effect model: MD = 58.6, 95% CI 40.4 to 76.8), and early pain intensity (VAS 1 day postoperatively with a fixed effect model: MD = 0.8, 95% CI 0.4 to 1.2). The two approaches did not differ in acetabular cup positioning angles and in functional outcome. Conclusions Our overall findings suggested that the short-term outcomes of THA through SuperPATH were superior to DAA. SuperPATH showed better results in decreasing operation time, incision length, intraoperative blood loss, and early pain intensity. DAA and SuperPATH were equal in functional outcome and acetabular cup positioning. |
| Related Links | https://josr-online.biomedcentral.com/counter/pdf/10.1186/s13018-021-02315-7.pdf |
| Ending Page | 17 |
| Page Count | 17 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| DOI | 10.1186/s13018-021-02315-7 |
| Journal | Journal of Orthopaedic Surgery and Research |
| Issue Number | 1 |
| Volume Number | 16 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2021-05-20 |
| Access Restriction | Open |
| Subject Keyword | Orthopedics Surgical Orthopedics |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery Orthopedics and Sports Medicine |
| Journal Impact Factor | 2.8/2023 |
| 5-Year Journal Impact Factor | 3/2023 |
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