The clinical efficacy of direct lateral approach versus traditional posterior approach for the treatment of total hip arthroplasty: a meta-analysis

Objective To compare the clinical efficacy between direct lateral approach and traditional posterior approach in the treatment of total hip arthroplasty by Meta-analysis. Methods The study included clinical trials published both at home and abroad from August 2008 to August 2018. The retrieval was performed in the online databases include Embase, Pubmed, PQDT, China National Knowledge Infrastructure (CNKI), CQVIP, Wanfang Data, CBM, etc. Statistical software Review Manager 5.3 was used for data-analysis. Results Based on the above search strategy to search papers, a total of 441 relevant literatures were retrieved, and eventually 12 literatures were included. The outcome measurements include 5 aspects such as harris hip score, range of motion, complications, time of surgery, trendelenburg test. Results The analysis showed that the direct lateral approach was inferior to Traditional Posterior Approach in Hip extension activity[95% CI (-10.93- -7.01), P<0.001], and the Direct Lateral Approach was superior to Traditional Posterior Approach in Hip flexion activity[95% CI (8.87-12.70), P<0.001], Trendelenburg test[95% CI (1.53-13.68), P=0.007]. But in Harris hip score [95% CI (-0.14-0.62), P=0.21]; Complications [95% CI (0.29-1.07), P=0.08]; Time of surgery [95% CI (-7.31-5.94), P=0.84], there was no significant differences between the two procedures. Conclusions Both the direct lateral and traditional posterior approach in total hip arthroplasty can achieve good effect, and the complications and harris hip score are comparable. Although the direct lateral approach group is superior to the traditional posterior approach group in trendelenburg test, the direct lateral approach is still a safe and feasible treatment option.