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Cited 4 time in webofscience Cited 12 time in scopus
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Disadvantage during Perioperative Period of Total Hip Arthroplasty Using the Direct Anterior Approach: a Network Meta-Analysisopen access

Authors
Cha, YonghanYoo, Jun-ILKim, Jung-TaekPark, Chan-HoChoy, WonsikHa, Yong-ChanKoo, Kyung-Hoi
Issue Date
11-May-2020
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Total Hip Arthroplasty; Direct Anterior; Anterolateral; Harding; Gait Analysis
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.35, no.18
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
35
Number
18
URI
https://scholarworks.bwise.kr/gnu/handle/sw.gnu/6616
DOI
10.3346/jkms.2020.35.e111
ISSN
1011-8934
Abstract
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: 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: 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; 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). Conclusion: When performing THA with DAA, we should pay attention to increased operation time and blood loss.
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