Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (8): 1248-1257.doi: 10.3969/j.issn.2095-4344.1087

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Hip function after total hip arthroplasty through different approaches: a network meta-analysis

Zhang Chi1, Lü Haoyuan2, Zhang Xiaoyun3, Lin Zonghan3, Chen Yueping3, Dong Panfeng3, Feng Yang1   

  1. 1Graduate School, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 2First Clinical College, Hubei University of Chinese Medicine, Wuhan 430061, Hubei Province, China; 3Department of Orthopedics, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China
  • Online:2019-03-18 Published:2019-03-18
  • Contact: Lin Zonghan, Chief physician, Master supervisor, Department of Orthopedics, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China
  • About author:Zhang Chi, Master candidate, Graduate School, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81760796 (to CYP); the Key Project of Guangxi Health Department, No. S201419-05 (to CYP); the Discipline Training Project of Guangxi University of Chinese Medicine-Orthopedics Construction Project, No. 04B2017082 (to CYP)

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Abstract:

BACKGROUND: There are seven kinds of common surgical approaches for total hip arthroplasty, including the traditional posterior approach, modified Hardinge approach, small-incision posterior approach, direct anterior approach, Orthopdische Chirurgie Munchen approach, SuperPATH approach and double incision approach. There is no consensus on the best surgical approach for total hip arthroplasty. There is a lack of systematic review of the above seven surgical approaches.

OBJECTIVE: To compare the short- and long-term hip function after total hip arthroplasty by different surgical approaches.
METHODS: PubMed, Embase, The Cochrane Library, CBM, CNKI, WanFang and VIP databases were searched. According to the inclusion and exclusion criteria, literature screening, quality evaluation and data extraction were performed. A network meta-analysis of each measurement outcome was conducted using Stata software and R software.
RESULTS AND CONCLUSION: (1) A total of 25 randomized controlled trials including 2 253 hips involving the seven interventions were included. (2) Network meta-analysis showed that the postoperative short-term Harris hip scores of the traditional posterior approach were lower than those of the modified Hardinge approach, direct anterior approach, Orthopdische Chirurgie Munchen approach. The postoperative short-term Harris hip scores of the Orthopdische Chirurgie Munchen approach were higher than those of the SuperPATH approach. The postoperative long-term Harris hip scores of the small-incision posterior approach were higher than those of the other surgical approaches. (3) These results indicate that the surgical approach with the highest postoperative short-term Harris hip scores may be the Orthopdische Chirurgie Munchen approach. The surgical approach with the highest postoperative long-term Harris hip scores is the posterior approach of the small incision. The double-incision approach in short-term and long-term Harris hip scores may be the second preference. (4) The above conclusions need to be confirmed by a large number of randomized controlled trials that are well designed and cover a variety of surgical approaches.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Hip, Randomized Controlled Trials, Meta-Analysis, Tissue Engineering

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