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

Abstract

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.