The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China.
Orthopedics IV, Gansu Provincial Hospital, No. 204 Donggang West Road, Chengguan District, Lanzhou, China.
J Orthop Surg Res. 2023 Oct 10;18(1):764. doi: 10.1186/s13018-023-04233-2.
To systematically evaluate the clinical safety and efficacy of the direct superior approach and the conventional surgical approach.
From PubMed, Embase, the Cochrane Library, and China Knowledge Network up to January 30, 2023.
A total of 7 case series involving 4306 patients undergoing total hip arthroplasty were included, including 679 patients with direct superior approach. All outcome measures: Oxford Hip Score [MD = 0.30, 95% CI (- 0.87, 1.47), P = 0.62], Hip Harris Score [MD = - 0.18, 95% CI (- 0.86, 0.49), P = 0.59], intraoperative blood loss [MD = - 54.14, 95% CI (- 102.75,-5.52), P = 0.03], transfusion rate [MD = 0.49, 95% CI (0.29, 0.83), P = 0.008], Limb Length Differences [MD = - 0.21, 95% CI (0.02, 0.39), P = 0.03], Length of Stay [MD = - 0.61, 95% CI (- 0.69, - 0.52), P < 0.00001].
The DSA was superior to conventional access in terms of incision length, bleeding, postoperative transfusion rate, and early postoperative HHS. In addition, our study found that because the DSA has less tissue damage, it has the potential advantages of accelerating patient recovery after surgery, shortening hospitalization time, and reducing patient economic pressure, which can significantly improve patient quality of life and satisfaction.
系统评价直接前路和传统手术入路的临床安全性和疗效。
检索 PubMed、Embase、Cochrane 图书馆和中国知网，检索时间截至 2023 年 1 月 30 日。
共纳入 7 项病例系列研究，共计 4306 例接受全髋关节置换术的患者，其中 679 例采用直接前路入路。所有结局指标：牛津髋关节评分[MD＝0.30，95％CI（-0.87，1.47），P＝0.62]、髋关节 Harris 评分[MD＝-0.18，95％CI（-0.86，0.49），P＝0.59]、术中失血量[MD＝-54.14，95％CI（-102.75，-5.52），P＝0.03]、输血率[MD＝0.49，95％CI（0.29，0.83），P＝0.008]、肢体长度差异[MD＝-0.21，95％CI（0.02，0.39），P＝0.03]、住院时间[MD＝-0.61，95％CI（-0.69，-0.52），P＜0.00001]。
与传统入路相比，DSA 在切口长度、出血量、术后输血率和术后早期 HHS 方面具有优势。此外，我们的研究发现，由于 DSA 对组织的损伤较小，因此具有加速术后患者康复、缩短住院时间和减轻患者经济压力的潜在优势，从而显著提高患者的生活质量和满意度。
