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Meta-Analysis
. 2009 Dec;33(6):1473-81.
doi: 10.1007/s00264-009-0743-z. Epub 2009 Mar 11.

Minimally invasive total hip arthroplasty: a systematic review

T Cheng  1 , J G Feng, T Liu, X L Zhang
Affiliations
Meta-Analysis

Minimally invasive total hip arthroplasty: a systematic review

T Cheng et al. Int Orthop. 2009 Dec.

Abstract
in English, French

The purpose of this study was to compare the operative outcome between mini and standard incisions in total hip arthroplasty (THA). We identified 12 randomised or quasi-randomised control trials (RCT or qRCT) published between 1996 and 2008. Subgroup and sensitivity analyses were performed to evaluate the differences in results for surgical approach, trial quality, and follow-up duration. Operative time and blood loss were significantly reduced in the mini-incision group for studies with the posterior or posterolateral approach. Concerning postoperative complications, there were no significant differences between the two groups with no significant heterogeneity. No differences were observed between the two groups for Harris hip score and radiographic results except for cup anterversion. Although mini-incision appeared to have similar outcomes compared to standard incision, the follow-up is short-term according to current standards in THA. High-quality studies are required to compare the outcomes of these two procedures.

Le but de cette étude est de comparer le devenir opératoire des patients ayant bénéficié d'une prothèse totale de hanche par voie mini-invasive ou par incision standard. Nous avons identifié 12 publications d'essais randomisés ou quasi randomisés (RCT ou qRCT) publiées entre 1996 et 2008. Des sous-groupes ont été réalisés de façon à évaluer la différence des résultats selon l'approche chirurgicale, la qualité des essais et la durée du suivi. Le temps opératoire et les pertes sanguines étaient significativement moins importants dans le groupe mini-incision réalisé par voie postérieure ou postéro-latérale. Il n'y a pas de différence significative dans les complications postopératoires entre les deux groupes de même en ce qui concerne le score de Harris, les résultats radiologiques exceptés pour l'antéversion de la cupule. Cependant, la mini incision semble avoir un devenir comparable à l'incision standard, mais avec des suites plus rapides. Des études ultérieures de grande qualité seront nécessaires pour comparer le devenir de ces deux procédés.

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Figures

Fig. 1
Fig. 1
Methodological quality summary by using the Jadad Score
Fig. 2
Fig. 2
Forest plot for postoperative complication overall. CI confidence interval, WMD weighted mean difference
See this image and copyright information in PMC

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