A comparison of clinical, radiographic and surgical outcomes of total hip arthroplasty between direct anterior and posterior approaches: a systematic review and meta-analysis

被引:58
|
作者
Jia, Fangteng [1 ]
Guo, Bin [2 ]
Xu, Feixiang [1 ]
Hou, Yuechao [1 ]
Tang, Xiongfeng [1 ]
Huang, Lanfeng [1 ]
机构
[1] Jilin Univ, Hosp 2, Dept Orthopaed, 218 Ziqiang St Nanguan Dist, Changchun 130041, Jilin, Peoples R China
[2] First Peoples Hosp Jinzhong, Dept Orthopaed, Jinzhong, Shanxi, Peoples R China
关键词
Direct anterior approach; meta-analysis; posterior approach; surgical approach; total hip arthroplasty; FEMORAL CUTANEOUS NERVE; TOTAL KNEE; MUSCLE DAMAGE; REPLACEMENT; THA; DISLOCATION; REHABILITATION; FLUOROSCOPY; EXPERIENCE; FRACTURES;
D O I
10.1177/1120700018820652
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Objective: A systematic review and meta-analysis were used to directly evaluate the direct anterior approach (DAA) and the posterior approach (PA) for early efficacy and safety of total hip arthroplasty (THA). Methods: Control-led trials assessing DAA and PA for the efficacy and safety of THA were searched in the database. Articles were reviewed according to predetermined inclusion and exclusion criteria; the quality of the methodology included in a given study was strictly assessed before data extraction. Moreover, meta-analysis was performed for outcomes that can be combined; otherwise, descriptive analysis was performed. Results: There were 20 articles included, with a total of 7377 patients. Among these, 3728 and 3649 cases were in the DAA and PA groups, respectively. There was no difference between the DAA and PA groups at postoperative week 2 in the number of patients using the assistive ambulatory device or in time needed to completely discontinue all assistive ambulatory devices. Descriptive analysis found that DAA was slightly better than PA regarding early functional recovery and activity after surgery, as well as postoperative pain relief. Hospitalisation stay in the DAA group was shorter than in the PA group, in which the patients had a shorter operative time. Radiographic outcomes showed that there was little difference in prosthetic position between the DAA and PA groups. The proportions of intraoperative fractures and postoperative lateral cutaneous nerve of the thigh (LCNT) neuropraxia were significantly higher in the DAA group than in patients who underwent PA. Conclusion: Compared with PA, DAA presents superior early recovery following THA.
引用
收藏
页码:584 / 596
页数:13
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