SynthesisActa orthopaedica2018
Influence of surgical approach on complication risk in primary total hip arthroplasty.
Synthesis in Acta orthopaedica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Pooled it
- Comparing direct anterior approach versus posterior approach or lateral approach in total hip arthroplasty: a systematic review and meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Pooled it
- Periprosthetic joint infection rates across primary total hip arthroplasty surgical approaches: a systematic review and meta-analysis of 653,633 procedures.Archives of orthopaedic and trauma surgery · 2022Pooled it
- The role of the femoral component orientation on dislocations in THA: a systematic review.Archives of orthopaedic and trauma surgery · 2022Pooled it
- Risk factors and modes of failure in the modern dual mobility implant. A systematic review and meta-analysis.BMC musculoskeletal disorders · 2021Pooled it
- Nerve palsy, dislocation and revision rate among the approaches for total hip arthroplasty: a Bayesian network meta-analysis.Musculoskeletal surgery · 2021Pooled it
- A systematic review and meta-analysis of the hip capsule innervation and its clinical implications.Scientific reports · 2021Pooled it
- Clinical, functional and radiographic outcomes of primary total hip arthroplasty between direct anterior approach and posterior approach: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2020Pooled it
- "E-Spot" (Obturator 'E'xternus Tendon Femoral Origin) as an Intraoperative Landmark for Femoral Preparation During "Off-Table" Anterior Approach.Arthroplasty today · 2026Article
- Managing Complications of Total Hip Arthroplasty for Avascular Necrosis Hip Performed Via Anterior Approach.Journal of orthopaedic case reports · 2026Article
- Patient reported outcomes during the first month following anterior and posterior total hip arthroplasty and hip resurfacing.BMC musculoskeletal disorders · 2025Article
- Observational
- Anterior total hip arthroplasty is associated with lower risk of revision but higher odds of delayed wound healing.Archives of orthopaedic and trauma surgery · 2025Article
- Intraprosthetic Dislocation Following Dual Mobility Total Hip Arthroplasty: A Retrieval Analysis Study.Arthroplasty today · 2025Article
- Comparison of surgical efficacy between direct anterior approach and posterolateral approach in the treatment of sarcopenia with femoral neck fractures.BMC geriatrics · 2024Article
- Article
- Leg length discrepancy after total hip arthroplasty performed by direct anterior approach: a systematic review comparing surgical approaches and strategies for prevention.EFORT open reviews · 2024Article
- Dislocation of primary total hip arthroplasty: Analysis of risk factors and preventive options.World journal of orthopedics · 2024Review
- Time trends in case-mix and risk of revision following hip and knee arthroplasty in public and private hospitals: a cross-sectional analysis based on 476,312 procedures from the Dutch Arthroplasty Register.Acta orthopaedica · 2024Article
- Evaluation of Outcome after Total Hip Arthroplasty for Femoral Neck Fracture: Which Factors Are Relevant for Better Results?Journal of clinical medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Systematic comparisons of anterior approach (A) versus posterior approach (P) in primary total hip arthroplasty (THA) have largely focused on perioperative outcomes. In this systematic review with meta-analysis, we compared complication risk of A versus P in studies of primary THA with at least 1-year mean follow-up. Patients and methods - We performed a systematic review of prospective and retrospective studies with at least 1-year mean follow-up that reported complications of A and P primary THA. Complications included infection, dislocation, reoperation, thromboembolic event, heterotopic ossification, wound complication, fracture, and nerve injury. Random effects meta-analysis was used for all outcomes. Complication risk was reported as rate ratio (RR) to account for differential follow-up durations; values >1 indicated higher complication risk with A and values <1 indicated lower risk with A. Results - 19 studies were included; 15 single-center comparative studies with 6,620 patients (2,278 A; 4,342 P) and 4 multicenter registries with 157,687 patients (18,735 A; 138,952 P). Median follow-up was 16 (12-64) months) with A and 18 (12-110) months with P. Anterior approach was associated with lower rate of infection (RR =0.55, p = 0.002), dislocation (RR =0.65, p = 0.03), and reoperation (RR =0.84, p < 0.001). No statistically significant differences were observed in rate of thromboembolic event (RR =0.59, p = 0.5), heterotopic ossification (RR =0.63, p = 0.1), wound complication (RR =0.93, p = 0.8), or fracture (RR =1.0, p = 0.9). There was a higher rate of patient-reported nerve injury with A (RR =2.3, p = 0.01). Interpretation - Comparing A with P in primary THA, A was associated with lower risk of reoperation, dislocation, and infection, but higher risk of patient-reported nerve injury.
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