Fourth Department of Orthopaedics, KAT Hospital, Athens, Greece.
Second Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Int Orthop. 2022 Aug;46(8):1681-1692. doi: 10.1007/s00264-022-05442-w. Epub 2022 Jun 1.
Using serum biomarkers, this systematic review assessed soft tissue injury following different total hip arthroplasty surgical approaches. The purposes were to determine if there is any advantage between the standard and minimal invasive approaches, and to compare tissue damage of the respective surgical approaches using biomarkers such as creatine kinase, myoglobin, c-reactive protein, erythrocyte sedimentation rate, skeletal troponin and interleukins.
A search in Pubmed/MEDLINE, Scopus and Web of Science databases was conducted in October 2021 with the use of PRISMA guidelines. Search items were ("biomarkers" OR "markers" OR "tissue damage" OR "muscle damage") AND "approach" AND ("total hip arthroplasty" OR "total hip replacement"). Inclusion criteria were prospective, randomized, controlled trials or prospective, comparative studies, comparing serum markers for muscle damage in two or more surgical approaches for primary total hip arthroplasty. Exclusion criteria were study protocols, case reports, systematic reviews, meta-analyses, studies in non-English language or without available full text, and studies not recording biomarkers of muscle damage.
Initial search revealed 508 studies; after subtraction of duplicates, and exclusion criteria, 31 studies remained for analysis. No advantage between different approaches was found when evaluating biomarkers, and no specific biomarkers had a distinct role in tissue damage in total hip arthroplasty. Anterior and minimally invasive approaches were associated with lower values of soft tissue (creatine kinase) and inflammation (c-reactive protein) biomarkers compared to the standard approaches.
Measurement of serum biomarkers after primary total hip arthroplasty for the estimation of tissue damage has unclear or little clinical value.
PROSPERO Registration: CRD42022303959.
本系统评价使用血清生物标志物评估不同全髋关节置换手术入路后的软组织损伤。目的是确定标准入路和微创入路之间是否存在任何优势，并使用肌酸激酶、肌红蛋白、C 反应蛋白、红细胞沉降率、骨骼肌钙蛋白和白细胞介素等生物标志物比较各自手术入路的组织损伤。
2021 年 10 月，使用 PRISMA 指南在 Pubmed/MEDLINE、Scopus 和 Web of Science 数据库中进行了搜索。搜索项为（“生物标志物”或“标志物”或“组织损伤”或“肌肉损伤”）和“方法”和（“全髋关节置换术”或“全髋关节置换术”）。纳入标准为前瞻性、随机对照试验或前瞻性、比较研究，比较两种或多种手术方法用于原发性全髋关节置换术的肌肉损伤血清标志物。排除标准为研究方案、病例报告、系统评价、荟萃分析、非英语语言或无法提供全文的研究，以及未记录肌肉损伤生物标志物的研究。
最初的搜索显示有 508 项研究；减去重复项和排除标准后，有 31 项研究仍需进行分析。在评估生物标志物时，不同方法之间没有发现优势，也没有特定的生物标志物在全髋关节置换术中对组织损伤有明显作用。与标准方法相比，前侧入路和微创入路与软组织（肌酸激酶）和炎症（C 反应蛋白）标志物的较低值相关。
原发性全髋关节置换术后测量血清生物标志物估计组织损伤的临床价值不明确或较小。
PROSPERO 注册：CRD42022303959。
