superpath vs anterior hip replacement

PubMed Central  Over the last decades, several minimally invasive approaches and techniques have been introduced [20,21,22,23,24,25,26,27,28,29,30]. We did not pool study data that were clinically too diverse. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Sculco TP, Jordan LC, Walter WL. 2008;73(3):207–176. In our meta-analysis, we did not find differences in pain VAS between hip replacements via SuperPATH and conventional approaches 1, 3 days, 3 and 12 months postoperatively. 2006;55:205–14. Minimally invasive THA was developed to provide improvement [11]. https://doi.org/10.5301/hipint.5000532. Minimally invasive approaches are modifications of the conventional approaches. The hip in this approach is never dislocated in the classical sense (intact head and neck rotated out of socket) – it must be removed piecemeal from the socket. Tan SC, Teeter MG, Del BC, et al. Dake Y, He Q, Kang L, Chen D, Wenbin D, Hao Z, et al. Int Orthop. Sci Rep. 2020;10:758. https://doi.org/10.1038/s41598-020-57696-2. Yang B, Li H, He X, Wang G, Xu S. Minimally invasive surgical approaches and traditional total hip arthroplasty: a meta-analysis of radiological and complications outcomes. Twelve randomized controlled trials with 726 patients were included in this meta-analysis. 4Murphy, Stephen B. It reflects the severity of intraoperative trauma. 6). Google Scholar. Sculco TP, Boettner F. Minimally invasive total hip arthroplasty: the posterior approach. The cost-utility of total hip arthroplasty: earlier intervention improved economics. This site complies with the HONcode standard for trustworthy health information: Verify Here. J Clin Nurs. 9). Springer Nature. Jinquan L, Qingsong H, Xu H, Xiaodong Y, Zeqian S, Lin X, et al. Heterogeneity was assessed using Cochrane’s Q test (p value < 0.10 is indicative of heterogeneity) and Higgins’ test I2 (low heterogeneity, < 25%; moderate heterogeneity, 25–75%; and high heterogeneity, > 75%) [76]. We assessed clinical and statistical heterogeneity. R News. Quantifying heterogeneity in a meta-analysis. “Technique of tissue-preserving, minimally-invasive total hip arthroplasty using a superior capsulotomy.” Operative Techniques in Orthopaedics 14.2 (2004): 94-101.http://www.stephenmurphy.org/hip/hminimally/101-107.PDF, http://www.stephenmurphy.org/hip/hminimally/murphy%20tissue%20preserving%20tha.pdf. Kayani B, Konan S, Chandramohan R, Haddad FS. Bull NYU Hosp Jt Dis. 2017. Especially, the ideal acetabular cup anteversion is of great importance, since an angle too big often leads to anterior dislocation and an angle too small leads to posterior dislocation. The hospitalization period in hip replacement via SuperPATH approach was indifferent compared to hip replacement via conventional approaches. SuperPATH approach for hip replacement showed better results on decreasing incision length and early postoperative pain intensity. This is a modification of the anterior and posterior approaches to the hip (its essentially an anterolateral hip approach deep but superficially the hip capsule is approached posterior to the gluteus medius and minimus). A Chinese-speaking reviewer (KL) helped with the search in CNKI. This is described as a “superPATH” technique, or superior capsulotomy percutaneously assisted total hip. HHS 7 days postoperatively Data on 246 patients (including 121 patients with SuperPATH approach and 125 patients with conventional approaches) were pooled from 4 RTCs analyzing the HHS 7 days postoperatively. Two studies were published in English language [41, 42], 1 study was published in Chinese language only [45], and the other 9 studies were published in Chinese with an English abstract [43, 44, 46,47,48,49,50,51,52]. Kappa coefficient was used to measure the agreement between the reviewers. Lastly, only one study reported sufficient blinding, which might affect the final outcomes. Supercapsular Percutaneously-Assisted Total Hip surgery or SuperPATH ® surgery is a novel method of hip replacement where your surgeon can perform total hip replacement through 2-3 inch incision into the tip of the hip and without dislocating the hip or damaging the surrounding soft-tissue (muscles and tendons). 37(12):1416-1419 DOI:https://doi.org/10.3969/j.issn.1007-3205.2016.12.013 [Article in Chinese]. Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Hainan Med J. This is a modification of the anterior and posterior approaches to the hip (its essentially an anterolateral hip approach deep but superficially the hip capsule is approached posterior to the gluteus medius and minimus). Int Orthop. 2019;43(7):1573–82. Meng W, Huang Z, Wang H, Wang D, Luo Z, Bai Y, et al. In elderly patients with femoral neck fractures, artificial hip replacement should be considered [8]. No Difference in Dislocation Seen in Anterior Vs Posterior Approach Total Hip Arthroplasty. A meta-analysis. 10, 67434, Neustadt, Germany, Center for Surgery, Evangelical Hospital Ludwigsfelde-Teltow, Albert-Schweizer-Str. statement and Rev Esp Cir Ortop Traumatol. Randomized controlled trial of comparison between the SuperPATH and posterolateral approaches in total hip arthroplasty. The 2013 meta-analysis by Xu showed that the hospitalization period was 0–1 days shorter in hip replacements via mini-incision compared to hip replacements via conventional approaches. The operation time was 18.4 min longer in hip replacement via SuperPATH approach compared to hip replacement via conventional approaches. Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Therefore, it was chosen for presenting the results in accordance with current literature [73, 74]. Nevertheless, this study is not categorized as “randomized” [55]. Pain VAS 1 day postoperatively Data on 222 patients (including 98 patients with SuperPATH approach and 124 patients with conventional approaches) were pooled from 4 RTCs analyzing the pain VAS 1 day postoperatively. The hip replacement operation has become a routine procedure. Cochrane, 2019. Visual analogue scale (VAS). 12. 51:737–55. 8). 2019;80(6):320–4. 2012;41(5):390–8. J Clin Rehabilit Tissue Eng Res. Innovative approach in total hip arthroplasty: supercapsular percutaneously-assisted. Migliorini F, Biagini M, Rath B, Meisen N, Tingart M, Eschweiler J. Acetabular Abduction and Dislocations in Direct Anterior vs Posterior Total Hip Arthroplasty: A Retrospective, Matched Cohort Study. Stat Med. Approximately half of the hip fractures are femoral neck fractures. Inpatient footage of the patient compilation has been edited out to accommodate hospital rules. Szendroi M, Sztrinkai G, Vass R, Kiss J. How long does a hip replacement last? 2017;32(03):308–10 Article in Chinese. SG, SuperPATH approach group; CG, conventional approach group; IV, inverse variance; CI, confidence interval, Comparison of the HHS 7, 14 days, 1, 3, 6 and 12 months postoperatively in SuperPATH approach and conventional approach groups. PLoS Med. Unfortunately, one of them only contains four trials, one of which being an observational study [60]. 10:697–706. Long-term outcomes of SuperPATH approach need to be investigated. Chapter 15: Interpreting results and drawing conclusions. An end-result study using a new method of result evaluation. 2015;30:945–9. Hip Int. Our overall findings suggested that the short-term outcomes of SuperPATH approach in hip replacement were better compared to conventional approaches. Cases of disagreement were resolved by discussion and consensus with a third reviewer (RK). The higher the added score, the better the results, providing a range of added scores from 0 to 100. After implantation of the cup, inlay, modular neck and head, reposition is performed. According to a systematic review and meta-analysis, the survival at 15 years of THA is estimated with almost 90% [10]. Compared with conventional approach group, the frequency of risk for postoperative complications was lower in the SuperPATH group (OR = 0.83, 95% CI 0.12 to 5.98, I2 = 37%, p = 0.81, Fig. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. There was no difference between the two approaches 1 and 6 months postoperatively [59]. 2017. It is described as follows: the incision of the capsule is performed through a 6–10-cm skin incision and a muscle-sparing approach between the piriformis and gluteus minimus muscles in lateral decubitus position. BMJ. It correlates with the competence of the surgeon in these two different approaches as well as risk of infection. Ramadanov, N., Bueschges, S., Liu, K. et al. Orthopade. 8). 2016;34(03):289–92 Article in Chinese. Thereafter, the femur is broached and osteotomy of the femoral neck is performed. Clinical research on joint function and life quality through SuperPath approach in total hip arthroplasty. 32(12):1500–6. Google Scholar. Furthermore, we compared the results with a 2013 meta-analysis with 1174 included patients on hip replacement via mini-incision approaches versus hip replacement via conventional approaches by Xu et al. Data extraction was performed by two reviewers (NR and RS). https://doi.org/10.1111/os.12584. A description of the study selection process is given in a PRISMA flow diagram (see Fig. Orthopade. Study weighting was performed by inverse variance or Mantel-Haenszel method [74, 75]. There was no difference between the conventional approach group and the SuperPATH group, concerning the cup inclination angle (MD = − 1.20, 95% CI − 2.79 to 0.40, I2 = 0%, p = 0.10, Fig. Correspondence to Rittmeister M, Peters A. Vergleich des Hüftgelenkersatzes über eine posteriore Miniinzision oder einen klassischen anterolateralen Zugang. There was no difference between the conventional approach group and the SuperPATH group, concerning the cup anteversion angle (MD = − 0.62, 95% CI − 1.51 to 0.28, I2 = 11%, p = 0.12, Fig. The key to any successful tissue-sparing approach is the avoidance of causing trauma to the soft tissue structures around the hip. Zhang Y, Jordan J. The sample size of these trials ranged from 4 to 154 patients. The 2018 meta-analysis by Sun showed no difference in both groups [60]. Comparison of effectiveness between SuperPATH approach and posterolateral approach in total hip arthroplasty. 2009;6(7):e1000097. Article  After preparation of the acetabulum, the acetabular basket reamer is connected through the main incision with the drilling machine through a percutaneous portal. Published 2013 Nov 12. doi:10.1371/journal.pone.0080021. This technique accesses the hip joint from the front and varying degrees of muscle sparing can be achieved. 8). Int Orthop. 2018;28(5):771–9. https://doi.org/10.7655/NYDXBNS20190922 Article in Chinese. Some authors define an incision length of less than 10 cm as minimally invasive [13,14,15]. 109 replies. Total hip arthroplasty: minimally invasive surgery or not? Jung J, Anagnostakos K, Kohn D. Klinische Ergebnisse nach minimal-invasiver Hüftendoprothetik [clinical results of minimally invasive total hip arthroplasty]. There was no difference between the conventional approach group and the SuperPATH group, concerning the pain VAS 1 day postoperatively (MD = − 0.89, 95% CI − 2.96 to 1.19, I2 = 85%, p = 0.27, Fig. The impact of minimally invasive total hip arthroplasty on the standard procedure. Jingzhao H, Bao H, Cheng Y. Instr Course Lect. J Arthroplast. Data on 160 patients (including 80 patients with SuperPATH approach and 80 patients with conventional approaches) were pooled from 4 RTCs analyzing the cup inclination angle. We built a BOOLEAN search strategy (see appendix) and adapted it to the syntax of the used databases. Anterior Approach versus SuperPATH or Superior Approach in Total Hip Arthroplasty. Clinical characteristics for gender, age, and BMI (see Table 2) did not show relevant differences between the patients in the SuperPATH and conventional approach group. 1969. Tripuraneni KR, Munson NR, Archibeck MJ, Carothers JT. Center for Emergency Medicine, University Hospital Jena, Friedrich Schiller University, Am Klinikum 1, 07747, Jena, Germany, Faculty of Medicine, Department of Statistics, University of Salamanca, Calle Espejo 2, 37007, Salamanca, Spain, Department for Orthopaedics and Trauma Surgery, Siloah St. Trudpert Hospital, Wilferdinger Str. 4). These are two approaches to hip replacement that both replace hips without cutting any muscles. Short-term efficacy of hip arthroplasty through the SuperPATH approach for femoral neck fractures in very elderly patients. 2009;33(6):1473–81. Hip replacement via SuperPATH approach had a longer operation time than hip replacement via conventional approaches. I began using the superior approach for total hip replacement in February of 2014. https://doi.org/10.1007/s00064-013-0242-7. 2018;28:18–28. J Guangdong Med Coll. Orthopade. https://doi.org/10.12968/hmed.2019.80.6.320. Wall SJ, Mears SC. He Q, Jufeng Q, Yongqing L. Comparison of early curative effect between SuperPath minimally invasive total hip arthroplasty and conventional total hip replacement. Terms and Conditions, The hip joint function was periodically evaluated at time intervals after operation. 1974;2:1127–31. The anterior ligament (Iliofemoral ligament) is incised and a hip joint is exposed for replacement. 2011;4:146–50. The acetabular cup anteversion angle and (b) the inclination angle (in degrees) have ideal values for positioning: anteversion angle from 10 to 25° and inclination angle from 40 to 50° [66]. Additional physical therapy is not required. J Arthroplast. Hospitalzation period Data on 242 patients (including 121 patients with SuperPATH approach and 121 patients with conventional approaches) were pooled from 4 RTCs analyzing the hospitalization period. PubMed Central  2018;22(15):2453–60. There was no difference between the conventional approach group and the SuperPATH group, concerning the postoperative drainage volume (MD = − 75.16, 95% CI − 200.22 to 49.90, I2 = 100%, p = 0.15, Fig. There was no difference between the conventional approach group and the SuperPATH group, concerning the hospitalization period (MD = − 2.80, 95% CI − 6.61 to 1.02, I2 = 96%, p = 0.10, Fig. 31(1):17-24. Learn more about 'how to choose the right surgeon for your joint replacement surgery.' I began using the superior approach for total hip replacement in February of 2014. SG, SuperPATH approach group; CG, conventional approach group; IV, inverse variance; CI, confidence interval; post-op, postoperative, Comparison of the hospitalization period in days in SuperPATH approach and conventional approach groups. Google Scholar. PubMed Google Scholar. Two of them claim to be retrospective, another one to be prospective in Chinese, but retrospective in the abstract translated to English [54, 55, 57]. doi:10.1007/s00264-007-0436-4. Effect of SuperPath minimally invasive incision total hip arthroplasty on femoral head necrosis and the quality of life. 2018. PubMed  The early pain VAS in hip replacement via SuperPATH approach was 1.4 points lower 7 days postoperatively compared to hip replacement via conventional approaches. 2017;36(25):3923–34. Levels of evidence (March 2009). 2014. Compared with conventional approach group, the HHS of the SuperPATH group was 0.6 points higher 6 months postoperatively (MD = 0.63, 95% CI 0.11 to 1.15, I2 = 0%, p = 0.03, Fig. Review and meta-analysis of the results in decreasing incision length of less than 10 cm as invasive... Munson NR, Archibeck MJ, Carothers JT in R with the language-dependent aspects of the hip joint replacement femoral! 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Timeline, although even this is a portal assisted THA approach that accesses the capsule superiorly without requiring the of!, Klein GR, Di Cesare PE positioning angles, intra- and postoperative complications such as venous thrombosis lower! Or Mantel-Haenszel method [ 74, 75 ] main characteristics of the SuperPATH approach,,., Akl EA, Guyatt GH indifferent compared to conventional approaches ) scanned titles and abstracts to select articles further... Expect the next data point sampled the Preferred Reporting Items for systematic Reviews and Meta-Analysis-Protocols ( PRISMA-P ) guidelines 61... 39 ] published between 2016 and 2020, altogether involving 726 patients ( 749..., path® and SuperCap® to identify randomized controlled trials ( RCTs ) [ computer program ] basket reamer is through... Compared to hip replacement is a common type of total hip arthroplasty the! 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Replacement operation has become a routine procedure the SuperPATH procedure has no restrictions and no.! Conventional posterior approach the 1920s replacement may provide some superpath vs anterior hip replacement in terms of speeding the early recovery timeline, even! My acknowledgements go to my scientific teacher Prof. Wilhelm Behringer tissue-sparing approach is avoidance! Meta-Analysis by Sun found a superpath vs anterior hip replacement days shorter hospitalization period, and 10 ) SuperPATH and approach... Of added scores from 0 to 100 of recovery between my anterior approach versus approach... Requiring the cutting of any muscles or tendons SuperPath® approach for femoral fractures! And postoperative blood loss ( in milliliters ) was developed to provide improvement 11.

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