SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023
Comparing direct anterior approach versus posterior approach or lateral approach in total hip arthroplasty: a systematic review and meta-analysis.
Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07226973 (A Prospective, Single-Blinded, Partially Randomized Three-Cohort Study Comparing Manual Direct Anterior and Manual Posterior Approaches to a Non-Randomized Robotic Posterior Cohort for Total Hip Arthroplasty Using Gait Analysis), which is not on this map. Cited by 56 papers, 7 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.
A Prospective, Single-Blinded, Partially Randomized Three-Cohort Study Comparing Manual Direct Anterior and Manual Posterior Approaches to a Non-Randomized Robotic Posterior Cohort for Total Hip Arthroplasty Using Gait Analysis
Who cites it
56 citing papers in PubMed, 7 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Intrawound (local) antibiotic prophylaxis as an adjunct to systemic antibiotics to prevent periprosthetic joint infection (PJI) after total hip arthroplasty: a meta-analysis of cohort studies.Journal of orthopaedic surgery and research · 2026Pooled it
- Comparative efficacy of direct anterior approach versus conventional surgical approaches in total hip arthroplasty: a systematic review and meta-analysis of randomized clinical trials.Journal of orthopaedic surgery and research · 2025Pooled it
- Do Meta-Analyses of Total Hip Arthroplasty Produce Reliable Results? A Systematic Review and Meta-Epidemiological Study of Statistical Methods.Orthopaedic surgery · 2025Pooled it
- Comparison of direct anterior vs. posterior approach in primary total hip arthroplasty: a systematic review and meta-analysis on enhanced recovery after surgery.Frontiers in surgery · 2025Pooled it
- Pooled it
- Causes and risk factors for same-day discharge failure after total hip and knee arthroplasty: a meta-analysis.Scientific reports · 2024Pooled it
- Does intraoperative fluoroscopy improve acetabular component positioning and limb-length discrepancy during direct anterior total hip arthroplasty? A meta-analysis.Journal of orthopaedic surgery and research · 2023Pooled it
- The first decade of data from the Irish National Orthopaedic Register: trends in hip and knee arthroplasty, implant utilisation and patient outcomes.International orthopaedics · 2026Article
- Length of Hospital Stay between Direct Anterior Approach and Posterior Approach in Primary Total Hip Arthroplasty.Hip & pelvis · 2026Article
- Total Hip Arthroplasty in Bilateral Ankylosed Hip by Direct Anterior Approach: A Case Report with Technical Tips.Journal of orthopaedic case reports · 2026Article
- [Are early dislocations still a relevant quality indicator in primary total hip arthroplasty? : An analysis from two maximum-care endoprosthetic centers].Orthopadie (Heidelberg, Germany) · 2026Review
- Generalized joint hypermobility and functional recovery after THA for unilateral Hartofilakidis type C developmental dysplasia of the hip: a retrospective cohort study.Arthroplasty (London, England) · 2026Article
- Conversion Total Hip Arthroplasty From a Long Cephalomedullary Nail Through the Direct Anterior Approach.Arthroplasty today · 2026Article
- Review
- Review
- Safety of posterolateral approach with a polished cemented stem and a modular dual mobility implant in patients over 75 years old.Journal of orthopaedics · 2026Article
- Optimizing Outcomes in Total Femur Replacement: Complications, Management Strategies, and Lessons Learned.Medicina (Kaunas, Lithuania) · 2026Article
- Article
- The Hana Table Can Be Used for Successful and Safe Closed Reduction of Anterior and Posterior Total Hip Dislocations, Even in Prolonged Dislocation up to 36 Hours.Arthroplasty today · 2026Article
- Direct visualization-guided PENG block (Pericapsular nerve Group): optimizing postoperative analgesia in total hip arthroplasty.Journal of orthopaedic surgery and research · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are several approaches to THA, and each has their respective advantages and disadvantages. Previous meta-analysis included non-randomised studies that introduce further heterogeneity and bias to the evidence presented. This meta-analysis aims to present level I evidence by comparing functional outcomes, peri-operative parameters and complications of direct anterior approach (DAA) versus posterior approach (PA) or lateral approach (LA) in THA. PATIENTS AND
methodsA comprehensive multi-database search (PubMed, OVID Medline, EMBASE) was conducted from date of database inception to 1st December 2020. Data from randomised controlled trials comparing outcomes of DAA versus PA or LA in THA were extracted and analysed.
resultsTwenty-four studies comprising 2010 patients were included in this meta-analysis. DAA has a longer operative time (MD = 17.38 min, 95%CI: 12.28, 22.47 min, P < 0.001) but a shorter length of stay compared to PA (MD = - 0.33 days, 95%CI: - 0.55, - 0.11 days, P = 0.003). There was no difference in operative time or length of stay when comparing DAA versus LA. DAA also had significantly better HHS than PA at 6 weeks (MD = 8.00, 95%CI: 5.85, 10.15, P < 0.001) and LA at 12 weeks (MD = 2.23, 95%CI: 0.31, 4.15, P = 0.02). There was no significant difference in risk of neurapraxia for DAA versus LA or in risk of dislocations, periprosthetic fractures or VTE between DAA and PA or DAA and LA.
conclusionThe DAA has better early functional outcomes with shorter mean length of stay but was associated with a longer operative time than PA. There was no difference in risk of dislocations, neurapraxias, periprosthetic fractures or VTE between approaches. Based on our results, choice of THA approach should ultimately be guided by surgeon experience, surgeon preference and patient factors. LEVEL OF EVIDENCE I: Meta-analysis of randomised controlled trials.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.