Systematic evaluation of joint amnesia in patients after total hip replacement surgery with comparison between anterior and posterior approaches

Abstract

Aims A comparison of joint amnesia in patients undergoing total hip arthroplasty with direct anterior approach (DAA) and posterior approach (PA) was conducted through systematic evaluation. Methods Searched for literature on FJS in patients undergoing DAA and PA THA comparison surgery from the establishment of PubMed, EMbase, Web of Science, Cochrane Library, CBM,Wanfang, and VIP databases to February 13, 2023. After two researchers independently searched, screened literature, extracted data, and evaluated the quality of included studies according to the inclusion criteria, a meta-analysis was conducted using RevMan 5.3. Results A total of 1 RCT and 6 cohort studies were included. Meta-analysis results showed that at 1 month postoperatively [MD = 2.08, 95% CI (0.20, 3.96), P = 0.03], 3 months [MD = 10.08, 95% CI (1.20, 18.96), P = 0.03], and 1 year [MD = 6.74, 95% CI (1.30, 12.19), P = 0.02], DAA total hip arthroplasty had better FJS than PA, but there was no statistical significance in FJS scores between the two groups at 5 years postoperatively [MD = 1.35, 95% CI (-0.58, 3.28), P = 0.17]. Conclusion Current evidence shows that early FJS after THA with DAA is better than PA, and there is no significant difference between the two in long-term follow-up. However, due to the limited number of literatures included in this study, the above conclusions need to be further confirmed by the inclusion of more high-quality studies.