• Naomi Kobayashi, Emi Kamono, Kensuke Kameda, Yohei Yukizawa, Shu Takagawa, Hideki Honda, and Yutaka Inaba.
• Department of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama, Japan. naomik58@aol.com.
• Arch Orthop Trauma Surg. 2023 Mar 1; 143 (3): 168916971689-1697.

IntroductionAlthough several surgical approaches, with or without capsular repair, can be used during total hip arthroplasty (THA), there is no clear evidence that capsular repair provides a clinical advantage post-surgery, regardless of surgical approach. This systematic review and meta-analysis evaluated whether capsular repair using various surgical approaches provides a clinical advantage over capsular resection post-THA.MethodsThis study was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 checklist for systematic reviews and meta-analyses. Multiple comprehensive literature searches were performed. Results were summarized qualitatively as meta-analysis of pooled odds ratios, and the standardized mean difference, with 95% confidence intervals for each group: capsular repair or capsular resection. A P value < 0.05 was considered statistically significant. Each study was evaluated for the risk of bias. Publication bias was also assessed.ResultsA total of 12 studies were included after screening and eligibility assessment. The odds ratio for hip dislocation after capsular repair was 0.14 (P < 0.00001). The standard mean difference of the Harris Hip Score (HHS) after capsular repair was 1.11 (P = 0.02). There were no significant differences between groups with respect to operation time (P = 0.79) and blood loss (P = 0.42).ConclusionThe current meta-analysis suggests that capsular repair leads to lower dislocation rates and a better HHS after THA.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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