Objective: A systematic review and meta-analysis were used to directly evaluate the direct anterior approach (DAA) and the posterior approach (PA) for early efficacy and safety of total hip arthroplasty (THA). Methods: Control-led trials assessing DAA and PA for the efficacy and safety of THA were searched in the database. Articles were reviewed according to predetermined inclusion and exclusion criteria; the quality of the methodology included in a given study was strictly assessed before data extraction. Moreover, meta-analysis was performed for outcomes that can be combined; otherwise, descriptive analysis was performed. Results: There were 20 articles included, with a total of 7377 patients. Among these, 3728 and 3649 cases were in the DAA and PA groups, respectively. There was no difference between the DAA and PA groups at postoperative week 2 in the number of patients using the assistive ambulatory device or in time needed to completely discontinue all assistive ambulatory devices. Descriptive analysis found that DAA was slightly better than PA regarding early functional recovery and activity after surgery, as well as postoperative pain relief. Hospitalisation stay in the DAA group was shorter than in the PA group, in which the patients had a shorter operative time. Radiographic outcomes showed that there was little difference in prosthetic position between the DAA and PA groups. The proportions of intraoperative fractures and postoperative lateral cutaneous nerve of the thigh (LCNT) neuropraxia were significantly higher in the DAA group than in patients who underwent PA. Conclusion: Compared with PA, DAA presents superior early recovery following THA.

Osteoarthritis (OA) poses a growing threat to the health of the global population. Accumulation of advanced glycation end-products (AGEs) has been shown to upregulate expression of degradative enzymes such as matrix metalloproteinases (MMPs) and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) in chondrocytes, which leads to excessive degradation of type II collagen and aggrecan in the articular extracellular matrix (ECM). In the present study we investigated the effects of the GLP-1 agonist lixisenatide, a widely used type II diabetes medication, on AGEs-induced decreased mitochondrial membrane potential (MMP), degradation of ECM, oxidative stress, expression of cytokines including interleukin (IL)-1b and IL-6, and activation of nuclear factor kappa B (NF-jB). Our findings indicate that lixisenatide significantly ameliorated the deleterious effects of AGEs in a dosedependent manner. Thus, lixisenatide has potential as a safe and effective treatment for OA and other AGEs-induced inflammatory diseases.