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A Systematic Review and Meta-Analysis of the SuperPATH Approach in Hip Arthroplasty
Yanzhi Ge1, Zuxiang Chen1, Qisong Chen2
1The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, 310053 Zhejiang, China.
Objective:
To compare the clinical and radiographic results of the supercapsular percutaneously assisted total hip (SuperPATH) approach and the conventional approach in hip arthroplasty.
Design:
Based on a prepublished protocol (PROSPERO: CRD42020177717), we searched PubMed, Embase, and Cochrane for relevant literatures up to January 30, 2021. The methodological qualities were assessed using the guidelines provided by the Cochrane Collaboration for Systematic Reviews. Randomized- or fixed-effect models were used to calculate the weighted mean difference (WMD) or odds ratio (OR), respectively, for continuous and dichotomous variables.
Results:
6 articles were included in the study, and 526 patients were selected, which included 233 cases in the SuperPATH groups and 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, -5.69), P < 0.00001), decreased blood transfusion rate (OR = 0.48, 95% CI (0.25, 0.89), P = 0.02), decreased visual analogue scale (VAS) (WMD = -0.40, 95% CI (-0.72, -0.08), P = 0.02), and higher Harris hip score (HHS) (WMD = 1.98, 95% CI (0.18, 3.77), P = 0.03) than the conventional group. However, there was no difference in VAS (P = 0.14) and HHS (P = 0.86) between the two groups 3 months later, nor in the acetabular abduction angle (P = 0.32) in either group.
Conclusions:
SuperPATH, as a minimally invasive approach with its reduced tissue damage, quick postoperative recovery, and early rehabilitation, demonstrates the short-term advantages of hip arthroplasty. As the evidences in favor of the SuperPATH technique were limited in a small number of studies and short duration of follow-up, more research is required to further analyze its long-term effect.
