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 h...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.展开更多
文摘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.
