Evidence map›Paper›PMID 39033274›Full record

Observational studyJournal of orthopaedic surgery and research2024

Learning curve and initial outcomes of a novel percutaneously endoscopic-assisted total hip arthroplasty through mini bikini direct anterior approach: an observational cohort study.

Guiguan Wang, Yiyang Xu, Guoyu Yu, Fenqi Luo, Long Chen, Yuan Lin, Jie Xu

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Guiguan Wang *Shengli Clinical College of Fujian Medical University, No.134 East Street, Fuzhou, Fujian, China.
Yiyang Xu *Shengli Clinical College of Fujian Medical University, No.134 East Street, Fuzhou, Fujian, China.
Guoyu Yu *Shengli Clinical College of Fujian Medical University, No.134 East Street, Fuzhou, Fujian, China.
Fenqi LuoShengli Clinical College of Fujian Medical University, No.134 East Street, Fuzhou, Fujian, China.
Long ChenShengli Clinical College of Fujian Medical University, No.134 East Street, Fuzhou, Fujian, China.
Yuan LinShengli Clinical College of Fujian Medical University, No.134 East Street, Fuzhou, Fujian, China. qingqing1405@163.com.
Jie XuShengli Clinical College of Fujian Medical University, No.134 East Street, Fuzhou, Fujian, China. jiexud@126.com.

Funding

Fujian Provincial Natural Science Foundation Projects 2021J01376Fujian Provincial Natural Science Foundation Projects 2021J01399Major Scientific Research Project of Fujian Province 2021ZD01003Science and Technology Planning Project of Fujian Province 2021GGB001
6 · The paper itself

Abstract

objectiveAlthough the direct anterior approach can reduce muscle damage and ensure accurate prosthesis placement, the steep learning curve and increased risk of complications associated with DAA necessitate careful consideration. Therefore, we describe a technique for a novel percutaneously endoscopic-assisted total hip arthroplasty through mini bikini direct anterior approach (mDAA) and report the learning curve and initial outcomes.

methodsThe first 125 THA performed by a single surgeon between September 2020 and February 2022 using the anterior approach were included, comprising the initial 41 cases of bikini DAA (bDAA) and the subsequent 84 cases of mDAA. Outcome measures included perioperative outcomes and postoperative complications. The cumulative sum analysis (CUSUM) was used to determine the learning curve of anterior approach THA for each patient's ORT. Multivariable analysis was performed to determine risk correlation.

resultsA total of 125 anterior approach THA completed between 2020 and 2022 were identified. Among these, 41 were performed via bDAA and 84 via mDAA. No statistically significant differences were observed between the groups in terms of age, gender distribution, BMI or follow-up time. A significant reduction in ORT was noted, from 140 min for bDAA to 130 min for mDAA. Furthermore, there was a consistent decrease in LOI, LOS, and wound-healing problems. There was no statistically significant difference between groups with respect to Harris Hip Scores and other postoperative complications. The curve inflection points of the learning curve for the bDAA and mDAA group were located in the 22nd and 68th cases, respectively. The reduction of hemoglobin indicated a predicted increase in ORT.

conclusionsIn this study, ORT, LOI, LOS, and wound-healing problems decreased overall in mDAA group. After mastering the bDAA technique, approximately 27 mDAA cases are needed to acquire proficiency in this technique. Hence, mDAA is a valuable alternative for those seeking smaller incisions, resolving wound healing problems, and aiming for enhanced recovery after surgery.

Indexed as

Arthroplasty, Replacement, HipEndoscopyLearning CurvePostoperative ComplicationsAdultAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedOperative TimeTreatment OutcomeDirect anterior approachEndoscopic-assistedLearning curvePercutaneouslyToal hip arthroplasty

Identifiers

PMID39033274
PMCPMC11265093

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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.