Bibliographic Details
| Title: |
Indirect comparisons of traction table versus standard table in total hip arthroplasty through direct anterior approach: a systematic review and frequentist network meta-analysis. |
| Authors: |
Ramadanov, Nikolai, Voss, Maximilian, Hable, Robert, Prill, Robert, Hakam, Hassan Tarek, Salzmann, Mikhail, Dimitrov, Dobromir, Diquattro, Emanuele, Ostojic, Marko, Królikowska, Aleksandra, Becker, Roland |
| Source: |
Journal of Orthopaedic Surgery & Research; 6/29/2024, Vol. 19 Issue 1, p1-27, 27p |
| Subject Terms: |
PREVENTION of surgical complications, TOTAL hip replacement, TREATMENT effectiveness, META-analysis, SURGICAL blood loss, DESCRIPTIVE statistics, SURGICAL equipment, SYSTEMATIC reviews, MEDLINE, ODDS ratio, ORTHOPEDIC traction, ONLINE information services, CONFIDENCE intervals |
| Abstract: |
Background: It remains unclear whether the use of an orthopaedic traction table (TT) in direct anterior approach (DAA) total hip arthroplasty (THA) results in better outcomes. The aim of this systematic review and network meta-analysis was to compare the THA outcomes through DAA on a standard operating table and the THA outcomes through DAA on a TT. Methods: PubMed, Epistemonikos, and Google Scholar were searched for relevant randomized controlled trials (RCTs) up to 01 January 2024. An indirect comparison in network meta-analysis was performed to assess treatment effects between DAA on a TT and DAA on a standard table, using fixed-effects and random-effects models estimated with frequentist approach and consistency assumption. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated for continuous variables and odds ratios (ORs) with 95% CIs were estimated for binary variables. Results: The systematic review of the literature identified 43 RCTs with a total of 2,258 patients. DAA with TT had a 102.3 mL higher intraoperative blood loss and a 0.6 mmol/L lower Hb 3 days postoperatively compared with DAA without TT (SMD = 102.33, 95% CI 47.62 to 157.04; SMD = − 0.60, 95% CI − 1.19 to − 0.00). DAA with TT had a 0.15 lower periprosthetic fracture OR compared with DAA without TT (OR 0.15, 95% CI 0.03 to 0.86). There were no further significant differences in surgical, radiological, functional outcomes and in complication rates. Conclusion: Based on our findings and taking into account the limitations, we recommend that particular attention be paid to the risk of periprosthetic fracture in DAA on a standard operating table and blood loss in DAA with TT. Since numerous other surgical, radiological, functional outcome parameters and other complication rates studied showed no significant difference between DAA on a standard operating table and DAA with TT, no recommendation for a change in surgical technique seems justified. Level of evidence: Level I evidence, because this is a systematic review and meta-analysis of randomized controlled trials. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Orthopaedic Surgery & Research is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| Database: |
Complementary Index |
|
Full text is not displayed to guests. |
Login for full access.
|
