A Systematic Review and Meta-Analysis of the Standard Versus Mini-Incision Posterior Approach to Total Hip Arthroplasty
Section snippets
Materials and Methods
We conducted the systematic review and meta-analysis using methods described in the Cochrane Handbook for Systematic Reviews of Interventions [24] and in accordance with Preferred Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines [25]. The protocol for this systematic review is registered and available on the Prospero database CRD42013004943.
Results
Literature searches identified 941 articles and after screening in duplicate, 16 studies published between 2003 and 2014 were included in the review. An additional three records report different aspects of the same RCT 35., 36., 37., and have therefore been amalgamated to avoid duplication of data. Progress of articles through this review is summarised as a flow diagram in Fig. 1.
Discussion
This systematic review and meta-analysis is based on the highest quality evidence from RCTs and nRCTs, and broadly demonstrates clinical equivalence between the standard and mini-incision posterior approaches.
Several systematic reviews investigating minimally invasive or mini-incision surgery have been reported previously 48., 49.. These reviews group together all the different minimally invasive approaches making the findings too generalised. Our review specifically examines only the posterior
Acknowledgments
We are grateful for the assistance of study authors who contributed additional information to our systematic review and meta-analysis: David Farr, Jon Goosen and Young-Hoo Kim.
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Direct anterior approach vs. SuperPATH vs. conventional approaches in total hip replacement: A network meta-analysis of randomized controlled trials
2021, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :The lower blood loss is an important advantage of SuperPATH. In general, literature shows a superiority of mini-incision approaches in reducing blood loss compared to standard approaches [10,24,78]. However, DAA showed a higher blood loss than CAs in our meta-analysis.
Piriformis-Sparing Minimally Invasive Versus the Standard Posterior Approach for Total Hip Arthroplasty: A 10-Year Follow-Up of a Randomized Control Trial
2019, Journal of ArthroplastyCitation Excerpt :With regard to outcomes of minimally invasive posterior approaches in general, there is also a paucity of long-term data. A meta-analysis of 16 prospective studies investigating mini-incision posterior approaches in 2014 concluded that this had clinical equivalence to the standard posterior approach [8]. Maximum follow-up was 5 years in one of the studies [20], with only 5 other studies looking at outcomes greater than 1 year from surgery [7,21–24].
Randomized Clinical Trial of 2-Incision vs Mini-Posterior Total Hip Arthroplasty: Differences Persist at 10 Years
2017, Journal of ArthroplastyDirect anterior versus posterior approach for total hip arthroplasty: a multicentre, prospective, randomized clinical trial
2020, Canadian Journal of SurgeryCitation Excerpt :Patients underwent either the PA or DAA. The PA to the hip, which is considered to be a minimally invasive approach because of the smaller operative scar (under 10 cm), has been described by many authors24-27 and could potentially yield better results.28 The modified Hueter approach, based on the Smith-Peterson approach, was performed for the direct anterior minimally invasive surgery. 29,30
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2014.05.021.