• Yonghan Cha, Jun Il Yoo, Jung Taek Kim, Chan Ho Park, Wonsik Choy, Yong Chan Ha, and Kyung Hoi Koo.
• Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.
• J. Korean Med. Sci. 2020 May 11; 35 (18): e111.

BackgroundThe purpose of this study was to analyze complications of complete hip arthroplasty through systematic review and network meta-analysis of comparative studies of direct anterior approach (DAA), anterolateral approach (LA), and posterolateral approach (PA).MethodsProspective randomized controlled trials (RCTs) or quasi-experimental designs evaluating clinical outcomes of DAA, LA, and PA for complete hip arthroplasty are valid if they meet the following criteria: 1) Comparison of clinical outcomes between the three methods for main complete hip arthroplasty (total hip arthroplasty, THA); 2) Compared at least one of the following outcomes: blood loss, operating time, and transfusion volume; 3) Sufficient data were available to extract and pool, i.e., mean reported, standard deviation and number of subjects. A network meta-analysis was used to determine the results of treatment across various surgical approaches. Indirect comparisons between the two surgical approaches was made by borrowing details from the standard comparator (i.e., the posterior approach).ResultsEight prospective RCTs were included in the meta-analysis of the network. The operation time of the LA was longer than that of PA (standardized mean difference [SMD], 0.96; 95% confidence interval [CI], 0.74-1.18; P < 0.001). DAA also had significantly longer operation time than PA (SMD, 0.45; 95% CI, 0.24-0.66; P < 0.001). However, blood loss of the DAA was the highest compared to other approaches (SMD, 0.60; 95% CI, 0.39-0.82; P = 0.002).ConclusionWhen performing THA with DAA, we should pay attention to increased operation time and blood loss.© 2020 The Korean Academy of Medical Sciences.

15 keywords...

hide…