Center of Orthopaedics and Traumatology, University Hospital Brandenburg an der Havel, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.
Faculty of Medicine, Department of Statistics, University of Salamanca, Salamanca, Spain.
Sci Rep. 2022 Oct 6;12(1):16778. doi: 10.1038/s41598-022-20242-3.
SuperPATH is a novel approach to the hip joint that needs to be compared to other known surgical approaches. To conduct a network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing short-term outcomes of SuperPATH, direct anterior (DAA), and posterior/ posterolateral approaches (PA) in total hip joint arthroplasty (THA). We performed a systematic review on PubMed, CNKI, Embase, The Cochrane Library, Clinical trials, and Google Scholar up to November 30th, 2021. We assessed treatment effects between SuperPATH, DAA, and PA by performing a frequentist NMA, including a total of 20 RCTs involving 1501 patients. SuperPATH showed a longer operation time (MD = 16.99, 95% CI 4.92 to 29.07), a shorter incision length (MD = -4.71, 95% CI -6.21 to -3.22), a lower intraoperative blood loss (MD = -81.75, 95% CI -114.78 to -48.72), a higher HHS 3, 6 and 12 months postoperatively (MD = 2.59, 95% CI 0.59-4.6; MD = 2.14, 95% CI 0.5-3.77; MD = 0.6, 95% CI 0.03-1.17, respectively) than PA. DAA showed a higher intraoperative blood loss than PA and SuperPATH (MD = 91.87, 95% CI 27.99-155.74; MD = 173.62, 95% CI 101.71-245.53, respectively). No other relevant differences were found. In conclusion, the overall findings suggested that the short-term outcomes of THA through SuperPATH were statistically superior to PA. DAA and PA as well as SuperPATH and DAA showed indifferent results.
SuperPATH 是一种新的髋关节入路方法，需要与其他已知的手术方法进行比较。我们对 PubMed、CNKI、Embase、The Cochrane Library、ClinicalTrials 和 Google Scholar 进行了系统检索，检索时间截至 2021 年 11 月 30 日，以评估 SuperPATH、直接前方（direct anterior，DAA）和后外侧（posterior/posterolateral，PA）入路在全髋关节置换术（total hip arthroplasty，THA）中的短期结果。我们纳入了 20 项随机对照试验（randomized controlled trials，RCTs），共 1501 例患者，采用传统的荟萃分析（meta-analysis，MA）和网络荟萃分析（network meta-analysis，NMA）比较 SuperPATH、DAA 和 PA 的治疗效果。SuperPATH 组的手术时间更长（MD=16.99，95%可信区间[confidence interval，CI] 4.92 至 29.07），切口长度更短（MD=-4.71，95%CI-6.21 至-3.22），术中出血量更少（MD=-81.75，95%CI-114.78 至-48.72），术后 3、6 和 12 个月髋关节功能评分更高（MD=2.59，95%CI 0.59 至 4.6；MD=2.14，95%CI 0.5 至 3.77；MD=0.6，95%CI 0.03 至 1.17），而 PA 组则相反。DAA 组的术中出血量多于 PA 组和 SuperPATH 组（MD=91.87，95%CI 27.99 至 155.74；MD=173.62，95%CI 101.71 至 245.53），而 SuperPATH 组和 DAA 组之间无差异。综上所述，总体而言，SuperPATH 组的短期疗效优于 PA 组，DAA 组和 PA 组、SuperPATH 组和 DAA 组之间无差异。
