Comparison of Clinical Outcomes of Supercapsular Percutaneously-assisted Approach Total Hip Arthroplasty Versus Conventional Posterior Approach for Total Hip Arthroplasty in Adults: A Systematic Review and Meta-Analysis

Abstract

OBJECTIVE: This meta-analysis was aimed to compare the postoperative results between SuperPATH and conventional posterior/posterolateral approach (PA). METHODS: PRISMAP guidelines were followed in this review. CNKI, Wanfang, PubMed, Embase, Cochrane, and Web of Science databases were searched for qualified studies according to the inclusion criteria, and extracted and analyzed the data by Review Manage 5.4 and Stata 16.0. RESULTS: 36 studies were included. Compared to PA group, SP group had a shorter incision length, less intraoperative blood loss, a shorter hospital stay, ability to act earlier and less postoperative drainage. Hip function (HHS) was significantly improved within three months postoperatively. Pain of hip (VAS) was significantly reduced within one month postoperatively. The state of daily living (BI) was significantly improved within three months. Patients' overall health status (SF-36 score) improved significantly postoperatively. There was no difference in postoperative complications between the two approaches. PA had a shorter operative time and a higher accuracy of prosthesis placement. CONCLUSION: SuperPATH is worth promoting. It is superior to conventional PA in terms of shorter hospital stay, less blood loss, shorter patient's postoperative bed rest, acceleration of postoperative hip function, and reduction of postoperative pain. However, it requires a longer operative time and implantation of the prosthesis is less accurate than that of PA. SuperPATH requires continued learning by surgeons to minimize the impact of its shortcomings.