Department of Orthopaedic Surgery, Xiangya Hospital Central South University, Changsha, China.
Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Changsha, China.
ANZ J Surg. 2021 May;91(5):E271-E279. doi: 10.1111/ans.16604. Epub 2021 Jan 22.
Whether there is any clinical superiority for the two-incision total hip arthroplasty (THA) over the mini-posterior THA remains controversial. The present meta-analysis aimed to comprehensively compare the clinical outcomes between the two mini-invasive THAs.
Two authors searched the database of Web of Science, PubMed, EMBASE and Cochrane Library to screen eligible studies individually. The quality evaluation of included studies was performed according to the principle of risk-of-bias of the Cochrane Library. The pooled results were analysed by Review Manager 5.3 software.
A total of seven prospective studies (including five randomized controlled trials) with 423 hips were finally included for meta-analysis. The pooled results revealed that the mini-posterior THA outperformed the two-incision THA in shortening operative times, reducing blood loss and postoperative fracture risks, while no significant difference was found between the two surgery methods with respect to HSS scoring, SF-12 scoring, postoperative function recovery and other postoperative complications.
Based on the pooled results, we suggested the mini-posterior THA as a preferable choice for patients suffering from severe advanced hip diseases.
两切口全髋关节置换术（THA）与小切口后侧入路 THA 相比是否具有任何临床优势仍存在争议。本荟萃分析旨在全面比较两种微创 THA 的临床结果。
两位作者分别搜索了 Web of Science、PubMed、EMBASE 和 Cochrane Library 的数据库，以筛选合格的研究。根据 Cochrane 图书馆的偏倚风险原则对纳入研究进行质量评估。使用 Review Manager 5.3 软件进行汇总结果分析。
最终纳入了 7 项前瞻性研究（包括 5 项随机对照试验）共 423 髋进行荟萃分析。汇总结果显示，小切口后侧入路 THA 在缩短手术时间、减少出血量和术后骨折风险方面优于两切口 THA，而两种手术方法在 HSS 评分、SF-12 评分、术后功能恢复和其他术后并发症方面无显著差异。
基于汇总结果，我们建议对于患有严重晚期髋关节疾病的患者，选择小切口后侧入路 THA 作为首选。
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