The efficacy and safety of direct superior approach (DSA) for total hip arthroplasty: a systematic review and meta-analysis

OBJECTIVE: To systematically evaluate the clinical safety and efficacy of the direct superior approach and the conventional surgical approach. DATE SOURCES: From PubMed, Embase, the Cochrane Library, and China Knowledge Network up to January 30, 2023. MAIN RESULTS: A total of 7 case series involving...

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Autores principales: Zhang, Zhuangzhuang, Zhang, Fukang, Yang, Xin, Fan, Hua, Cheng, Qinghao, Guo, Hongzhang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563322/
https://www.ncbi.nlm.nih.gov/pubmed/37817232
http://dx.doi.org/10.1186/s13018-023-04233-2
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author Zhang, Zhuangzhuang
Zhang, Fukang
Yang, Xin
Fan, Hua
Cheng, Qinghao
Guo, Hongzhang
author_facet Zhang, Zhuangzhuang
Zhang, Fukang
Yang, Xin
Fan, Hua
Cheng, Qinghao
Guo, Hongzhang
author_sort Zhang, Zhuangzhuang
collection PubMed
description OBJECTIVE: To systematically evaluate the clinical safety and efficacy of the direct superior approach and the conventional surgical approach. DATE SOURCES: From PubMed, Embase, the Cochrane Library, and China Knowledge Network up to January 30, 2023. MAIN RESULTS: A total of 7 case series involving 4306 patients undergoing total hip arthroplasty were included, including 679 patients with direct superior approach. All outcome measures: Oxford Hip Score [MD = 0.30, 95% CI (− 0.87, 1.47), P = 0.62], Hip Harris Score [MD = − 0.18, 95% CI (− 0.86, 0.49), P = 0.59], intraoperative blood loss [MD = − 54.14, 95% CI (− 102.75,-5.52), P = 0.03], transfusion rate [MD = 0.49, 95% CI (0.29, 0.83), P = 0.008], Limb Length Differences [MD = − 0.21, 95% CI (0.02, 0.39), P = 0.03], Length of Stay [MD = − 0.61, 95% CI (− 0.69, − 0.52), P < 0.00001]. CONCLUSIONS: The DSA was superior to conventional access in terms of incision length, bleeding, postoperative transfusion rate, and early postoperative HHS. In addition, our study found that because the DSA has less tissue damage, it has the potential advantages of accelerating patient recovery after surgery, shortening hospitalization time, and reducing patient economic pressure, which can significantly improve patient quality of life and satisfaction.
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spelling pubmed-105633222023-10-11 The efficacy and safety of direct superior approach (DSA) for total hip arthroplasty: a systematic review and meta-analysis Zhang, Zhuangzhuang Zhang, Fukang Yang, Xin Fan, Hua Cheng, Qinghao Guo, Hongzhang J Orthop Surg Res Systematic Review OBJECTIVE: To systematically evaluate the clinical safety and efficacy of the direct superior approach and the conventional surgical approach. DATE SOURCES: From PubMed, Embase, the Cochrane Library, and China Knowledge Network up to January 30, 2023. MAIN RESULTS: A total of 7 case series involving 4306 patients undergoing total hip arthroplasty were included, including 679 patients with direct superior approach. All outcome measures: Oxford Hip Score [MD = 0.30, 95% CI (− 0.87, 1.47), P = 0.62], Hip Harris Score [MD = − 0.18, 95% CI (− 0.86, 0.49), P = 0.59], intraoperative blood loss [MD = − 54.14, 95% CI (− 102.75,-5.52), P = 0.03], transfusion rate [MD = 0.49, 95% CI (0.29, 0.83), P = 0.008], Limb Length Differences [MD = − 0.21, 95% CI (0.02, 0.39), P = 0.03], Length of Stay [MD = − 0.61, 95% CI (− 0.69, − 0.52), P < 0.00001]. CONCLUSIONS: The DSA was superior to conventional access in terms of incision length, bleeding, postoperative transfusion rate, and early postoperative HHS. In addition, our study found that because the DSA has less tissue damage, it has the potential advantages of accelerating patient recovery after surgery, shortening hospitalization time, and reducing patient economic pressure, which can significantly improve patient quality of life and satisfaction. BioMed Central 2023-10-10 /pmc/articles/PMC10563322/ /pubmed/37817232 http://dx.doi.org/10.1186/s13018-023-04233-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Systematic Review
Zhang, Zhuangzhuang
Zhang, Fukang
Yang, Xin
Fan, Hua
Cheng, Qinghao
Guo, Hongzhang
The efficacy and safety of direct superior approach (DSA) for total hip arthroplasty: a systematic review and meta-analysis
title The efficacy and safety of direct superior approach (DSA) for total hip arthroplasty: a systematic review and meta-analysis
title_full The efficacy and safety of direct superior approach (DSA) for total hip arthroplasty: a systematic review and meta-analysis
title_fullStr The efficacy and safety of direct superior approach (DSA) for total hip arthroplasty: a systematic review and meta-analysis
title_full_unstemmed The efficacy and safety of direct superior approach (DSA) for total hip arthroplasty: a systematic review and meta-analysis
title_short The efficacy and safety of direct superior approach (DSA) for total hip arthroplasty: a systematic review and meta-analysis
title_sort efficacy and safety of direct superior approach (dsa) for total hip arthroplasty: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563322/
https://www.ncbi.nlm.nih.gov/pubmed/37817232
http://dx.doi.org/10.1186/s13018-023-04233-2
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