Comparative cohort study of the SuperPath approach and the conventional posterior approach in primary cementless hip replacement surgery

Martínez, Jesús Más; Sanz-Reig, J.; Morales-Santías, M.; Puga, David Bustamante Suarez de; Roman, Carmen Verdu; Giménez, E. Martínez

doi:10.1016/j.recote.2019.07.002

“…Since its introduction, several studies were conducted to reveal differences in outcomes of Super-PATH approach in comparison to conventional approaches in hip replacement. The conclusions of these studies are varying [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58]. While English literature on this subject appears sparse [40][41][42], most of the studies are published in Chinese [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57].…”

Section: Introductionmentioning

confidence: 99%

Comparison of short-term outcomes between SuperPATH approach and conventional approaches in hip replacement: a systematic review and meta-analysis of randomized controlled trials

Ramadanov

¹

,

Bueschges

²

,

Liu

³

et al. 2020

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Background It remains uncertain if the new SuperPATH approach benefits patients in artificial hip joint replacement. We conducted a systematic review and meta-analysis of randomized controlled trials to compare the short-term outcome of SuperPATH approach and conventional approaches in hip joint replacement. Methods A systematic literature search up to April 2020 was performed to identify randomized controlled trials comparing SuperPATH with conventional approaches in hip joint replacement. We measured surgical, functional, and radiological outcomes. Mean differences or odds ratios with 95% confidence intervals were calculated and pooled using random effects models and the Hartung-Knapp-Sidik-Jonkman method. Results A total of 12 RCTs involving 726 patients met the inclusion criteria, one trial with a level I evidence, 11 trials with level II evidence. The overall meta-analysis showed that SuperPATH approach reduced incision length (MD = − 4.84, 95% CI − 7.04 to − 2.64, p < 0.01), pain VAS 7 day postoperatively (MD = − 1.39, 95% CI − 2.57 to − 0.21, p = 0.03), and HHS 7 day postoperatively (MD = 10.24, 95% CI 0.27 to 20.21, p = 0.05). The two approaches did not differ in acetabular cup positioning angles, intra- and postoperative blood loss, hospitalization period, and postoperative complications. Hip replacement via SuperPATH approach had a longer operation time than hip replacement via conventional approaches. Conclusions SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. Long-term outcomes of SuperPATH approach need to be investigated.

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“…To further read the full text, we found a lack of required data in 9 pieces of literature and 3 pieces of literature included other irrelevant interventions. Finally, 6 articles [10][11][12][13][14][15]were selected. The PRISMA literature inclusion and exclusion process were shown in Fig.…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…3 and 4. As shown in Table 2, the NOS scores of these three cohort studies [12][13][14] were 8, 8 and 8, respectively. In general, all of the 6 articles included in this study were of good quality, with standardized research design and good research value.…”

Section: The Basic Characteristics and Quality Evaluation Of Includedmentioning

confidence: 96%

“…6 studies [10][11][12][13][14][15] recorded intraoperative blood loss. Because of statistical heterogeneity (Chi² = 402.99, df = 5, I² = 99%, p < 0.00001), random effects models were applied.…”

Section: Intraoperative Blood Lossmentioning

confidence: 99%

“…Newcastle-Ottawa Scale for Risk of Bias Assessment of Cohort Studies Included in the Meta-AnalysisFig. 5) was recorded in 6 studies[10][11][12][13][14][15] and random effects models were used because of the statistical heterogeneity of the results (Chi² = 44.29, df = 5, I² = 89%, p < 0.00001). The results showed that there was no signi cant difference between two groups (WMD = 6.81, 95% CI − 1.47 to 15.09, p = 0.11).…”

mentioning

confidence: 99%

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A systematic review and meta-analysis of SuperPATH approach in hip arthroplasty

Ge

¹

,

Zhou

²

,

Chen

³

et al. 2020

Preprint

0

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Background: To compare the clinical and radiographic results of supercapsular percutaneously assisted total hip (SuperPATH) approach and conventional approach by systematic review and meta-analysis. Methods: Based on a pre-published protocol (PROSPERO CRD42020177717), we systematically retrieved databases from Pubmed, Embase, Cochrane and Web of Knowledge for relevant literatures from the earliest available date to May 30, 2020. No language restriction was applied. RevMan 5.3 software was used to perform the meta-analysis. The methodological qualities were assessed using the guidelines provided by the Cochrane Collaboration for Systematic Reviews. Two reviewers were independently extracted data from all eligible studies, including types of studies, participants, interventions, and outcomes. Randomized or fixed-effect models were used to calculate the weighted mean difference (WMD), odds ratio (OR) for continuous and dichotomous variables, respectively.Results: 6 articles were included in the study and 526 patients were selected, which was including 233 cases in the SuperPATH groups, 279 cases in the conventional groups and 4 cases performed two surgeries in succession. The SuperPATH group demonstrated shorter incision length (WMD = - 7.87, 95 % CI - 10.05 to - 5.69, P < 0.00001), decreased blood transfusion rate (OR = 0.48, 95 % CI 0.25 to 0.89, P = 0.02), decreased visual analogue scale (VAS) (WMD = -0.40, 95 % CI - 0.72 to - 0.08, P = 0.03) and higher Harris hip score (HHS) (WMD = 1.98, 95 % CI 0.18 to 3.77, P = 0.0002) than those in the conventional group. However, there was no difference in VAS and HHS between the two groups half a year later. There was no significant difference in the acetabular abduction angle (WMD = - 1.32, P = 0.32) in either group. Conclusions: SuperPATH minimally invasive approach with its reduced tissue damage, quick postoperative recovery and early rehabilitation demonstrates the short-term advantages of hip arthroplasty. However, the evidence for SuperPATH technique was limited in the number of studies and short duration of follow-up, so long-term results still need further analysis.

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A Systematic Review and Meta-Analysis of the SuperPATH Approach in Hip Arthroplasty

Ge

¹

,

Chen

²

,

Chen

³

et al. 2021

BioMed Research International

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Objective. To compare the clinical and radiographic results of the supercapsular percutaneously assisted total hip (SuperPATH) approach and the conventional approach in hip arthroplasty. Design. Based on a prepublished protocol (PROSPERO: CRD42020177717), we searched PubMed, Embase, and Cochrane for relevant literatures up to January 30, 2021. The methodological qualities were assessed using the guidelines provided by the Cochrane Collaboration for Systematic Reviews. Randomized- or fixed-effect models were used to calculate the weighted mean difference (WMD) or odds ratio (OR), respectively, for continuous and dichotomous variables. Results. 6 articles were included in the study, and 526 patients were selected, which included 233 cases in the SuperPATH groups and 279 cases in the conventional groups, and 4 cases performed two surgeries in succession. The SuperPATH group demonstrated shorter incision length ( WMD = − 7.87 , 95% CI (−10.05, −5.69), P < 0.00001 ), decreased blood transfusion rate ( OR = 0.48 , 95% CI (0.25, 0.89), P = 0.02 ), decreased visual analogue scale (VAS) ( WMD = − 0.40 , 95% CI (−0.72, −0.08), P = 0.02 ), and higher Harris hip score (HHS) ( WMD = 1.98 , 95% CI (0.18, 3.77), P = 0.03 ) than the conventional group. However, there was no difference in VAS ( P = 0.14 ) and HHS ( P = 0.86 ) between the two groups 3 months later, nor in the acetabular abduction angle ( P = 0.32 ) in either group. Conclusions. SuperPATH, as a minimally invasive approach with its reduced tissue damage, quick postoperative recovery, and early rehabilitation, demonstrates the short-term advantages of hip arthroplasty. As the evidences in favor of the SuperPATH technique were limited in a small number of studies and short duration of follow-up, more research is required to further analyze its long-term effect.

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Comparative cohort study of the SuperPath approach and the conventional posterior approach in primary cementless hip replacement surgery

Cited by 7 publications

References 18 publications

Comparison of short-term outcomes between SuperPATH approach and conventional approaches in hip replacement: a systematic review and meta-analysis of randomized controlled trials

Comparison of short-term outcomes between SuperPATH approach and conventional approaches in hip replacement: a systematic review and meta-analysis of randomized controlled trials

A systematic review and meta-analysis of SuperPATH approach in hip arthroplasty

A Systematic Review and Meta-Analysis of the SuperPATH Approach in Hip Arthroplasty

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