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Direct anterior approach versus posterolateral approach in total hip arthroplasty: a meta-analysis of results on early post-operative period
- Source :
- Journal of Orthopaedic Surgery and Research, Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-8 (2021)
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Background This study was performed to compare the advantage and disadvantage of posterolateral approach (PLA) and direct anterior approach (DAA) in total hip arthroplasty (THA). Methods Relevant trials were identified via a search of the Cochrane Central Register of Controlled Trials and PubMed from inception to 1 June 2019. A meta-analysis was performed to compare postoperative perioperative and radiographic outcomes between DAA and PLA in THA with respect to the hospital stay, blood loss, incision length, operative time, complications, and femoral and cup component position. The Harris Hip Score (HHS) was also assessed before and after 6 months postoperatively. Results Nine eligible studies involving 22698 adult patients (DAA group, n = 2947; PLA group, n = 19751) were identified for analysis. Compared with the PLA group, the DAA group had shorter hospital stay and achieved better HHS within 6 months after operation (P < 0.05), but the HHS was no significant differences between the two groups over 6 months (P > 0.05). The DAA group had significantly longer operative time, more blood loss, and complications than the PLA group (P < 0.05). In addition, the femoral component positioned in neutral and cup component inclination angle was comparable between both groups (P > 0.05); however, cup component anteversion angle was significantly larger in the PLA group (P < 0.05). Conclusion Patients in the DAA group had higher HHS within 6 months and shorter hospital stay. The DAA could offer rapid early functional recovery after THA compared with the PLA. However, the DAA group often required longer operative time and had more blood loss. Furthermore, there was a higher early complication rate. Therefore, we believe that the direct anterior approach was a more difficult technique. The surgeon should be a well-trained joint surgeon with extensive prior hip replacement experience before performing THA through a DAA, and DAA was not suitable for beginners performing THA. In addition, we did not observe the difference with regard to the femoral component position and cup component inclination angle except for the smaller cup component anteversion angle in DAA group.
- Subjects :
- Male
medicine.medical_specialty
lcsh:Diseases of the musculoskeletal system
Time Factors
Arthroplasty, Replacement, Hip
Radiography
Operative Time
Blood Loss, Surgical
Osteoarthritis, Hip
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
lcsh:Orthopedic surgery
Hip replacement
Humans
Medicine
Orthopedics and Sports Medicine
Postoperative Period
030212 general & internal medicine
Aged
030222 orthopedics
business.industry
Perioperative
Length of Stay
Middle Aged
Surgery
lcsh:RD701-811
Meta-analysis
Direct anterior approach
Treatment Outcome
Harris Hip Score
Orthopedic surgery
Posterolateral approach
Total hip arthroplasty
Female
Systematic Review
lcsh:RC925-935
business
Subjects
Details
- ISSN :
- 1749799X
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Journal of Orthopaedic Surgery and Research
- Accession number :
- edsair.doi.dedup.....36ac6a83638721c979f1cec478fd68e0