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Comparison of minimally invasive surgery and mini-incision technique for total hip arthroplasty: a sub-group
Xiang Zhao1, Tiao Lin, Xun-Zi Cai
1Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, China.
Background:
It is well accepted that the minimally invasive surgery (MIS) for total hip arthroplasty (THA) should combine with less or no muscle damage and is different from mini-incision technique and MIS should have better outcomes than mini-incision surgery. The aim of current analysis was to apply an explicitly defined sub-group analysis to confirm whether this hypothesis is true.
Methods:
A computerized literature search was applied to find any data concerning MIS or mini-incision THAs. A multistage screening was then performed to identify randomized studies fulfilling the inclusive criteria for the analysis. The data were extracted, and sub-group analyses of MIS or mini-incision surgery for different kinds of outcomes were carried out. The P(sub) value for difference between MIS sub-group and mini-incision sub-group was also calculated.
Results:
Eleven studies that fulfilling the inclusion criteria were included, with 472 cases in the study group (MIS or mini-incision) and 492 cases in the conventional group. The overall analysis showed the study group would achieve less surgical duration (P = 0.037), intraoperative blood (P < 0.001) and incision length (P < 0.001) than conventional group. The difference between sub-groups showed, the MIS would achieve shorter incision length (P(sub) < 0.05) and bigger cup abduction angle (P(sub) < 0.05), and cause more blood loss (P (sub) < 0.05) than mini-incision technique. Other indexes were comparable between the two sub-groups.
Conclusions:
Though further high quality studies are still needed, the result of current analysis offered an initial conclusion that MIS THA failed to achieve a better clinical outcome than mini-incision technique. The exact definition of MIS still needs to be improved.
Insights
Minimally invasive surgery (MIS) for total hip arthroplasty (THA) did not show better clinical outcomes than mini-incision techniques. While MIS THA resulted in shorter incisions, it also led to increased blood loss compared to mini-incision surgery.
Area of Science:
- Orthopedic Surgery
- Surgical Techniques
Background:
- Minimally invasive surgery (MIS) for total hip arthroplasty (THA) is hypothesized to offer superior outcomes compared to mini-incision techniques due to reduced muscle damage.
- The precise definition and comparative efficacy of MIS THA versus mini-incision THA require explicit investigation.
Purpose of the Study:
- To confirm whether MIS THA provides better clinical outcomes than mini-incision THA through a defined sub-group analysis.
- To compare specific surgical outcomes between MIS THA and mini-incision THA.
Main Methods:
- A systematic literature search identified randomized controlled trials comparing MIS or mini-incision THA with conventional THA.
- Data extraction and sub-group analyses were performed to compare outcomes between MIS and mini-incision THA groups.
- Statistical analysis, including P(sub) values, assessed differences between sub-groups.
Main Results:
- Eleven studies (472 MIS/mini-incision cases, 492 conventional cases) were included.
- Overall, MIS/mini-incision THA showed reduced surgical duration, intraoperative blood loss, and incision length compared to conventional THA.
- Sub-group analysis revealed MIS THA had shorter incisions and larger cup abduction angles but greater blood loss than mini-incision THA.
Conclusions:
- Current analysis suggests MIS THA does not achieve superior clinical outcomes compared to mini-incision THA.
- Further high-quality research is necessary to validate these findings.
- A clearer, standardized definition of MIS in THA is needed.
