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Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis

OBJECTIVE: To compare the outcomes of the direct anterior approach (DAA) with the lateral approach (LA) for total hip arthroplasty (THA) patients. METHODS: Three English databases, PubMed, Embase, and the Cochrane Library, were searched for randomized controlled trials (RCTs) comparing the DAA with...

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Autores principales: Wang, Zhao, Bao, Hong-wei, Hou, Jing-zhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390312/
https://www.ncbi.nlm.nih.gov/pubmed/30808382
http://dx.doi.org/10.1186/s13018-019-1095-z
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author Wang, Zhao
Bao, Hong-wei
Hou, Jing-zhao
author_facet Wang, Zhao
Bao, Hong-wei
Hou, Jing-zhao
author_sort Wang, Zhao
collection PubMed
description OBJECTIVE: To compare the outcomes of the direct anterior approach (DAA) with the lateral approach (LA) for total hip arthroplasty (THA) patients. METHODS: Three English databases, PubMed, Embase, and the Cochrane Library, were searched for randomized controlled trials (RCTs) comparing the DAA with LA for THA. Information on the country, sample size, intervention, outcomes, and follow-up were extracted. Meta-analysis was performed using Stata 12.0. RESULTS: Five RCTs totaling 475 patients (DAA = 236, LA = 239) were included in this meta-analysis. Compared with the LA, the DAA was associated with a reduction in the VAS at 6 weeks (weighted mean difference (WMD) = − 0.41, 95% confidence interval (CI) − 0.63 to − 0.19, P = 0.000) and total blood loss for THA patients (WMD = − 45.73, 95% CI − 84.72 to − 6.02, P = 0.024). Moreover, the DAA was associated with an increase in walking velocity (WMD = 5.01, 95% CI 2.32 to 7.70, P = 0.000), stride length (WMD = 3.12, 95% CI 2.42 to 3.82, P = 0.000), and step length (WMD = 4.09, 95% CI 1.03 to 7.14, P = 0.009) compared with the LA group. There was no significant difference between groups in the Harris hip score, operation time, transfusion rate, length of hospital stay, and the occurrence of complications. CONCLUSION: Current evidence demonstrated a trend showing that the DAA had a better effect on pain relief and blood-saving effects for THA patients. However, considering the number and sample size of the included trials, more large-scale RCTs with high quality are needed to confirm our conclusion.
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spelling pubmed-63903122019-03-19 Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis Wang, Zhao Bao, Hong-wei Hou, Jing-zhao J Orthop Surg Res Systematic Review OBJECTIVE: To compare the outcomes of the direct anterior approach (DAA) with the lateral approach (LA) for total hip arthroplasty (THA) patients. METHODS: Three English databases, PubMed, Embase, and the Cochrane Library, were searched for randomized controlled trials (RCTs) comparing the DAA with LA for THA. Information on the country, sample size, intervention, outcomes, and follow-up were extracted. Meta-analysis was performed using Stata 12.0. RESULTS: Five RCTs totaling 475 patients (DAA = 236, LA = 239) were included in this meta-analysis. Compared with the LA, the DAA was associated with a reduction in the VAS at 6 weeks (weighted mean difference (WMD) = − 0.41, 95% confidence interval (CI) − 0.63 to − 0.19, P = 0.000) and total blood loss for THA patients (WMD = − 45.73, 95% CI − 84.72 to − 6.02, P = 0.024). Moreover, the DAA was associated with an increase in walking velocity (WMD = 5.01, 95% CI 2.32 to 7.70, P = 0.000), stride length (WMD = 3.12, 95% CI 2.42 to 3.82, P = 0.000), and step length (WMD = 4.09, 95% CI 1.03 to 7.14, P = 0.009) compared with the LA group. There was no significant difference between groups in the Harris hip score, operation time, transfusion rate, length of hospital stay, and the occurrence of complications. CONCLUSION: Current evidence demonstrated a trend showing that the DAA had a better effect on pain relief and blood-saving effects for THA patients. However, considering the number and sample size of the included trials, more large-scale RCTs with high quality are needed to confirm our conclusion. BioMed Central 2019-02-26 /pmc/articles/PMC6390312/ /pubmed/30808382 http://dx.doi.org/10.1186/s13018-019-1095-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Systematic Review
Wang, Zhao
Bao, Hong-wei
Hou, Jing-zhao
Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis
title Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis
title_full Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis
title_fullStr Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis
title_full_unstemmed Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis
title_short Direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis
title_sort direct anterior versus lateral approaches for clinical outcomes after total hip arthroplasty: a meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390312/
https://www.ncbi.nlm.nih.gov/pubmed/30808382
http://dx.doi.org/10.1186/s13018-019-1095-z
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