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New research · Orthopedics
Cureus · 6d
ReviewCureus · 2024

Direct Anterior vs. Posterior Approach in Simultaneous Bilateral Total Hip Arthroplasty: A Meta-Analysis.

Elcio Machinski, Liron Leibovitch, Jae Yong Park … Caio Veloso Gusmão
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OrthopedicsReview

Direct anterior approach was associated with lower blood loss than posterior approach.

Direct Anterior vs. Posterior Approach in Simultaneous Bilateral Total Hip Arthroplasty: A Meta-Analysis.

Elcio Machinski … Caio Veloso Gusmão
Cureus · 2024
Background

Simultaneous bilateral total hip arthroplasty (simultaneous bilateral total hip arthroplasty) offers benefits such as reduced hospital stay and costs for patients with bilateral hip disease.

Purpose

This study aimed to compare the perioperative outcomes of simultaneous bilateral total hip arthroplasty performed via the direct anterior approach (direct anterior approach) versus the posterior approach (posterior approach).

Methods

A systematic review and meta-analysis were conducted, including studies reporting outcomes of simultaneous bilateral total hip arthroplasty using direct anterior approach and posterior approach.

n = 944 patients
Results

Blood loss was lower with the direct anterior surgical approach.

RR by subgroup · 95% CI
null = 1
two approaches
1.04
two
0.63
More results

However, the optimal surgical approach remains uncertain.

The primary outcome was the incidence of allogeneic blood transfusions, while secondary outcomes included blood loss and surgical complications, such as dislocations, periprosthetic fractures, and infections.

More results

No significant difference was observed in the number of allogeneic blood transfusions between the two approaches (RR = 1.04; 95% CI: 0.76 to 1.43; p=0.63).

However, there was no significant difference in the rates of surgical complications between the two groups (RR = 0.63; 95% CI: 0.32 to 1.26; p=0.12).

“
Conclusion

These findings highlight the need for further randomized controlled trials with standardized methodologies and longer follow-up periods to better assess the optimal approach for simultaneous bilateral total hip arthroplasty.

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