Disadvantage during Perioperative Period of Total Hip Arthroplasty Using the Direct Anterior Approach: a Network Meta-Analysis.


Journal

Journal of Korean medical science
ISSN: 1598-6357
Titre abrégé: J Korean Med Sci
Pays: Korea (South)
ID NLM: 8703518

Informations de publication

Date de publication:
11 May 2020
Historique:
received: 19 12 2019
accepted: 27 02 2020
entrez: 9 5 2020
pubmed: 10 5 2020
medline: 21 1 2021
Statut: epublish

Résumé

The 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). Prospective 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). Eight 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; When performing THA with DAA, we should pay attention to increased operation time and blood loss.

Sections du résumé

BACKGROUND BACKGROUND
The 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).
METHODS METHODS
Prospective 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).
RESULTS RESULTS
Eight 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;
CONCLUSION CONCLUSIONS
When performing THA with DAA, we should pay attention to increased operation time and blood loss.

Identifiants

pubmed: 32383362
pii: 35.e111
doi: 10.3346/jkms.2020.35.e111
pmc: PMC7211512
doi:

Types de publication

Journal Article Meta-Analysis Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e111

Informations de copyright

© 2020 The Korean Academy of Medical Sciences.

Déclaration de conflit d'intérêts

The authors have no potential conflicts of interest to disclose.

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Auteurs

Yonghan Cha (Y)

Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.

Jun Il Yoo (JI)

Department of Orthopaedic Surgery, Eulji University Hospital, Daejeon, Korea. furim@daum.net.

Jung Taek Kim (JT)

Department of Orthopedic Surgery, Ajou Medical Center, Ajou University School of Medicine, Suwon, Korea.

Chan Ho Park (CH)

Department of Orthopedic Surgery, Yeungnam University Medical Center, Daegu, Korea.

Wonsik Choy (W)

Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea.

Yong Chan Ha (YC)

Department of Orthopedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Kyung Hoi Koo (KH)

Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

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