Direct anterior vs other surgical approaches in patients with lumbar stiffness undergoing total hip arthroplasty: a systematic review and meta-analysis

被引：0

作者：

Leibovitch, Liron ^{[1
]}

Machinski, Elcio ^{[2
]}

Fernandes, Andre ^{[3
]}

Park, Jae Yong ^{[4
]}

Souza, Gabriel ^{[5
]}

Sayudo, Iqbal F. ^{[6
]}

Warschawski, Yaniv ^{[7
]}

Gusmao, Caio ^{[8
]}

机构：

[1] Bar Ilan Univ, Azrieli Fac Med, Dept Med, Safed, Israel

[2] Univ Estadual Ponta Grossa, Dept Med, Ponta Grossa, PR, Brazil

[3] York & Scarborough Natl Hlth Serv Fdn Trust, Dept Orthopaed & Trauma, York, England

[4] Imperial Coll, Sch Med, Dept Med, London, England

[5] Univ Fed Juiz de Fora, Dept Med, Juiz De Fora, Brazil

[6] Syiah Kuala Univ, Sch Med, Banda Aceh, Indonesia

[7] Tel Aviv Sourasky Med Ctr, Dept Orthoped, Tel Aviv, Israel

[8] Hosp Santa Teresa, Dept Orthopaed & Trauma, Petropolis, RJ, Brazil

来源：

ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY | 2024年 / 145卷 / 01期

关键词：

Total hip arthroplasty; Direct anterior approach; Dislocations; Spinopelvic motion; Lumbar spine fusion; FUSION;

D O I：

10.1007/s00402-024-05682-y

中图分类号：

R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学（修复外科学）];

学科分类号：

摘要：

IntroductionThe effectiveness of the direct anterior approach (DAA) compared to other surgical approaches for total hip arthroplasty (THA) in patients with lumbar spine stiffness remains unclear. This systematic review and meta-analysis aimed to compare clinical outcomes, including dislocation rates and other complications, between DAA and other surgical approaches for THA in patients with lumbar spine stiffness.Materials and methodsWe conducted a systematic review and meta-analysis to compare the DAA with other surgical approaches (anterolateral, direct lateral, posterolateral and direct superior) in patients with lumbar spine stiffness undergoing THA. We searched PubMed, Embase, and Cochrane Central databases for cohort studies and randomized controlled trials and calculated risk ratios (RRs) with 95% confidence intervals (CIs) to assess dislocation rates.ResultsThis analysis included 11 non-randomized studies comprising 2505 patients, of whom 738 patients (29.4%) underwent THA via DAA. The results demonstrated that the DAA group had significantly reduced dislocation rates (RR 0.31, 95% CI 0.14-0.67, P = 0.003, I2 = 0%) compared to other surgical approaches. Subgroup analysis showed significantly lower dislocation rates in DAA patients versus those undergoing the posterior approach (RR 0.22, 95% CI 0.10-0.52, P = 0.001, I2 = 0%). However, there was no statistically significant difference in dislocation rates between DAA and the lateral approach (RR 0.53, 95% CI 0.19-1.47, P = 0.22, I2 = 0%), although the rate was numerically lower.ConclusionThe DAA was associated with lower dislocation rates compared to other surgical techniques in patients with lumbar spine stiffness undergoing THA.

引用

页数：9

共 27 条

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