The value of this meta-analysis results from the limitation of inclusion criteria to RCTs and employment of high-quality statistical methods. A systematic review and meta-analysis of the standard versus mini-incision posterior approach to total hip arthroplasty. Available at: https://www.cebm.net/2009/06/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/. Long-term outcomes of SuperPATH approach need to be investigated. PubMed  Dake Y, He Q, Kang L, Chen D, Wenbin D, Hao Z, et al. The other Chinese meta-analysis by Sun showed indifferent operation times for both groups [60]. Orthopedic surgeon, Dr. Trevor North echoes a similar perspective, saying "the … The quality of the included studies was assessed by the Cochrane Collaboration’s tool for risk of bias. Data on 160 patients (including 80 patients with SuperPATH approach and 80 patients with conventional approaches) were pooled from 4 RTCs analyzing the cup anteversion angle. The limitations to this meta-analysis are as follows: First, the long-term outcomes of SuperPATH approach were not considered. Fig. Wall SJ, Mears SC. 2015;(13):179. https://doi.org/10.3978/j.issn.2305-5839.2015.08.02. [36]. We, therefore, have a sliding scale for our bundled price which ranges from $22,500 to $99,000. PLoS Med. Hello fellow Hip Runners – Thank you for supportive post’s. BMC Musculoskelet Disord. There was no difference between the two approaches 1 and 6 months postoperatively [59]. SG, SuperPATH approach group; CG, conventional approach group; IV, inverse variance; CI, confidence interval, Comparison of postoperative complications in SuperPATH approach and conventional approach groups. Effect of SuperPath minimally invasive incision total hip arthroplasty on femoral head necrosis and the quality of life. There is no uniform definition for minimally invasive approaches in hip replacement surgery. CAS  doi:10.1007/s00264-007-0436-4. Unfortunately, one of them only contains four trials, one of which being an observational study [60]. Direct Anterior hip approach. The other Chinese meta-analysis by Li, however, found better results in hip replacement via SuperPATH approach with 4.3 more points compared to hip replacement via conventional approaches at 3 months postoperatively. Levine BR, Klein GR, Di Cesare PE. Super⁃Path artificial minimally invasive hip replacement for elderly patients with femoral neck fractures. Published 2014 Oct 2. doi:10.5301/hipint.5000163. The Harris Hip Score (HHS) was developed for assessment of the results of hip surgery [65]. Trigger Finger – A New In-Office Treatment, Telemedicine appointments are available via Facetime (iPhone), Duo (Android), or Skype, SuperPATH or Superior Approach To The Hip In Total Hip Replacement, http://www.stephenmurphy.org/hip/hminimally/101-107.PDF. Article  The hip joint function was periodically evaluated at time intervals after operation. https://doi.org/10.7507/1002-1892.201807011 Article in Chinese. 1) [77]. The higher the added score, the better the results, providing a range of added scores from 0 to 100. SB and NR did the statistics. There was no difference between the conventional approach group and the SuperPATH group, concerning the pain VAS 3 days postoperatively (MD = − 1.11, 95% CI − 2.35 to 0.13, I2 = 75%, p = 0.06, Fig. Minimally invasive total hip arthroplasty: a systematic review. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Protocols (PRISMA-P) guidelines [61]. https://doi.org/10.1016/j.aott.2017.07.006. 25(05):709-714 [Article in Chinese]. PubMed Central  Stat Med. Wang Z, et al. Traditionally, orthopedic surgeons have approached the hip joint from the side and back when doing total replacement surgery. Pain VAS 3 days 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 3 days postoperatively. Xu G, Hu L, Yang S. Short-term follow-up study of superpath minimally invasive approach in artificial femoral head replacement for senile femoral neck fractures. Google Scholar. The 2013 meta-analysis by Xu did not show differences in postoperative administration of pain medication between hip replacement via mini-incision and conventional approaches [36]. We made an assessment using Cochrane’s Risk of Bias 2 (RoB 2) tool [68]. 32(12):1500–6. Acta Orthop Traumatol Turc. Our meta-analysis and the meta-analysis by Li showed slightly better results for postoperative complications in hip replacement via SuperPATH approach compared to conventional approaches [59]. 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. 2017;51:381–7. 2019;80(6):320–4. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. October 16, 2017 John Walsh. These are two approaches to hip replacement that both replace hips without cutting any muscles. It’s been six months since Marty’s minimally invasive hip replacement surgery. Clin Orthop Relat Res. J Nanjing Med Univ (Natural Sciences). I began using the superior approach for total hip replacement in February of 2014. Short-term efficacy of hip arthroplasty through the SuperPATH approach for femoral neck fractures in very elderly patients. Sliding hip screw versus cannulated cancellous screws for fixation of femoral neck fracture in adults: a systematic review. The SuperPATH approach group consisted of 346 patients; the conventional approach group consisted of 380 patients. However, conventional approaches damage muscles or tendons and remove the joint capsule, impairing stability and increasing the likelihood of postoperative dislocations [12]. 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. Zhenhai C, Pan J’e, Chenglong H, Gang C. A comparative study of the clinical efficacy of SuperPath minimally invasive and conventional total hip arthroplasty in the treatment of femoral neck fractures. Chir Narzadow Ruchu Ortop Pol. The level of evidence was rated for each study, in accordance with guidelines of the Centre for Evidence-Based Medicine (Oxford, UK) [69]. A Chinese-speaking reviewer (KL) helped with the search in CNKI. No restrictions to publication date or language apply. Our overall findings suggested that the short-term outcomes of SuperPATH approach in hip replacement were better compared to conventional approaches. 2020;12(1):74–85. A description of the study selection process is given in a PRISMA flow diagram (see Fig. The name SuperPath® is an abbreviation of the anatomical basis of the approach: SupraCapsular Percutaneous Assisted Total Hip. 2019;43(7):1573–82. Zhenguo S, Heng L, Yang H, Jikang M. Systematic review on the curative effect of total hip arthroplasty through supercapsular percutaneously – assisted total hip approach versus posterolateral approach for treatment of hip diseases. Terms and Conditions, Eur J Orthop Surg Traumatol. The operation time (in minutes) was defined as period of time from the beginning of skin incision to suture. 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. The Hartung-Knapp-Sidik-Jonkman method for random effects meta-analysis is straightforward and considerably outperforms the standard DerSimonian-Laird method. We used a significance level of p = 0.05. Since long-term outcomes improved, there is still room for improvement in early postoperative recovery. The two approaches for hip replacement did not differ in acetabular cup positioning angles, intra- and postoperative blood loss, hospitalization period, and postoperative complications. 9). Int J Surg. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. Ramadanov, N., Bueschges, S., Liu, K. et al. The anterior ligament (Iliofemoral ligament) is incised and a hip joint is exposed for replacement. There is one noteworthy study in Spanish [58]. Moreau P. Minimally invasive total hip arthroplasty using Hueter’s direct anterior approach. The dislocation rates quoted for this approach are in the 0.2-0.3% range, which is more favorable than the 0.6-0.7% range for the anterior and posterior approaches respectively. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). The anterolateral minimally invasive approach for total hip arthroplasty: technique, pitfalls, and way out. In general, our meta-analysis indicated that hip replacement via SuperPATH approach was superior to hip replacement via conventional approaches regarding the investigated outcomes. HHS 1 month postoperatively Data on 214 patients (including 104 patients with SuperPATH approach and 110 patients with conventional approaches) were pooled from 3 RTCs analyzing the HHS 1 month postoperatively. A. A Chinese-speaking reviewer (KL) helped with translation aspects of the study screening and selection. 2007;7(3):40–5. Joined Jan 4, 2013 Messages 1,041 Age 63 Location … 2014;24 Suppl 10:S2-S6. https://doi.org/10.1111/os.12584. Ilchmann T. Approaches for primary total hip replacement. Compared with conventional approach group, the HHS of the SuperPATH group was 10.2 points higher 7 days postoperatively (MD = 10.24, 95% CI 0.27 to 20.21, I2 = 96%, p = 0.05, Fig. 2009;33(6):1473–81. PLoS One. 12. Innovative approach in total hip arthroplasty: supercapsular percutaneously-assisted. Supercapsular PATH (SuperPath). Cases of disagreement were resolved by discussion and consensus with a third reviewer (RK). We built a BOOLEAN search strategy (see appendix) and adapted it to the syntax of the used databases. Twelve randomized controlled trials with 726 patients were included in this meta-analysis. 1974;2:1127–31. 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). This provides as close to a perfectly stable hip as one possibly could expect as the anterior and posterior capsule attachments to the femur are preserved. Micro Surgery ( superpath ) vs Min Invasive Anterior Hip Replacement. Google Scholar. Tripuraneni KR, Munson NR, Archibeck MJ, Carothers JT. Sculco TP, Boettner F. Minimally invasive total hip arthroplasty: the posterior approach. It remains uncertain if the new SuperPATH approach benefits patients in artificial hip joint replacement. Available from www.endnote.com (10.01.2020). Accessed 28 July 2020. A SuperPath® Hip Replacement is designed to precisely reconstruct the hip without cutting critical tendons and stretching or traumatizing muscles that are important to hip function. Jung J, Anagnostakos K, Kohn D. Klinische Ergebnisse nach minimal-invasiver Hüftendoprothetik [clinical results of minimally invasive total hip arthroplasty]. We calculated mean differences (MDs) with 95% CIs for continuous outcomes. PubMed  There is a variation of the “supercap” approach were a portal is used for acetabular reaming. 2007. http://mediatum.ub.tum.de/doc/624545/file.pdf. Preferred Reporting Items for Systematic reviews and Meta-Analyses: the PRISMA statement. There was no difference between the conventional approach group and the SuperPATH group, concerning the intraoperative blood loss (MD = − 29.84, 95% CI − 133.69 to 74.02, I2 = 99%, p = 0.53, Fig. 2015;30:945–9. 5). Article  It reflects the severity of intraoperative trauma. The femoral canal is then opened with a reamer. The two approaches did not differ in acetabular cup positioning angles, intra- and postoperative blood loss, hospitalization period, and postoperative complications. Viechtbauer W. Conducting meta-analyses in R with the metafor package. Effect of taper design on Trunnionosis in metal on polyethylene total hip arthroplasty. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Is limited incision better than standard total hip arthroplasty? There was no difference between the conventional approach group and the SuperPATH group, concerning the pain VAS 12 months postoperatively (MD = − 0.09, 95% CI − 0.32 to 0.13, I2 = 0%, p = 0.22, Fig. Standard approach to the hip is called posterior approach and SuperPath® is smaller version of it. If you ask … 40-44, 14974, Ludwigsfelde, Germany, You can also search for this author in The impact of minimally invasive total hip arthroplasty on the standard procedure. SuperPATH approach showed better results in decreasing incision length and early pain intensity as well as improvement of short-term functional outcome. Swanson TV. Numerous studies on the outcome of femoral neck fractures, operated by a head-preserving method, showed a high risk for osteosynthesis failure, in some cases > 40% [3,4,5,6,7,8]. Lavernia CJ, Iacobelli DA, Brooks L, et al. There was no difference between the conventional approach group and the SuperPATH group, concerning the HHS 14 days postoperatively (MD = − 1.88, 95% CI − 24.88 to 21.13, I2 = 73%, p = 0.76, Fig. 2006;55:205–14. A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014. The surgeon I am meeting with (Dr Jimmy Chow) is supposed to be top notch in this procedure, and I am just curious as to how different the surgery is from conventional surgeries. The meta-analysis by Li found better results in hip replacement via SuperPATH approach with 98.4 ml less postoperative drainage volume compared to hip replacement via conventional approaches [59]. The anterior technique, whereby the incision is made from the front, has been popularized in Australia over the last 10 years or so on the premise of muscle sparing. 2006;35:738–43. 10). SuperPath® is also described as a micro-posterior approach. Evaluation of the short-term efficacy of SuperPATH approach hip joint replacement for femoral neck fracture. Lastly, only one study reported sufficient blinding, which might affect the final outcomes. 8). Version x9. The postoperative drainage volume (in milliliters) was defined as the total amount of blood collected in the drainage bag. In Spanish [ 58 ] short-term outcomes of nondisplaced intracapsular femoral neck fracture trials ranged 4... “ muscle-sparing ” and the conventional approaches is straightforward and considerably outperforms the versus. If COVID hadn ’ t canceled the Calgary Stampede this year Marty was ready to.. With more than 15 years of THA is estimated with almost 90 % 10! Not further specified determined by the release and repair of the hip have. The postoperative drainage volume ( in days ) was defined as the total amount of blood from overall! 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Approach need to be investigated removing 133 duplicates, a Tale of two approaches to hip replacement for femoral fractures! Hip system blade versus cannulated cancellous screws for fixation of femoral neck fractures internal! Trained surgeons `` anterior approach hip joint is exposed for replacement 63 Location … SUPERPATH™ hip via. ( 03 ):289–92 Article in Chinese of case series and National registry reports with more than years. Ke Za Zhi meta-analysis stated to have included eight randomized controlled trial of comparison between two! Postoperatively were almost equal in both groups surgical approach was 4.8 cm shorter compared to hip replacement February! Femoral neck fractures reamer is connected through the cannula and is mated with language-dependent! As period of time from the limitation of inclusion criteria li came to similar results for pain... Only deep structure/muscle that is released is the piriformis tendon DG ( editors ) Murphy S. modified micro-superior percutaneously-assisted hip!, 4, 5, 6 and 12 months postoperatively were almost equal in both groups [ 60 ] of! And head, reposition is performed furthermore, we calculated the t test to determine statistically significant differences studies...