SynthesisArchives of orthopaedic and trauma surgery2024
A systematic review on revision total hip arthroplasty employing the direct anterior approach.
Synthesis in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis 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
1 citing paper in PubMed, 1 synthesis or guideline pooled 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
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe increased use of the direct anterior approach (DAA) for primary total hip arthroplasty (THA) has extended to revision THA. This systematic review evaluated studies reporting both the utility and clinical outcomes of revision THA using DAA, focusing on studies comparing revision approaches. MATERIALS AND
methodsA review of the Cochrane Library, EMBASE, and MEDLINE databases identified 577 publications. 538 were excluded after abstract screening. Full-text review identified 21 studies with 1627 patients. All studies were retrospective, level IV evidence. MINORS criteria rated 14 as poor and seven as moderate. Five studies compared DAA to alternative approaches. Meta-analysis was not performed due to significant heterogeneity and lack of comparative studies.
resultsThe most common indications for revision were aseptic loosening (n = 929) and polyethylene wear (n = 158). The majority of the studies (n = 11/21) performed primarily acetabular revision or head-liner exchanges. Half the revisions (50.6%; n = 823/1627) included femoral revisions (35.2%; n = 573/1627) or combined femoral-acetabular revisions (15.4%; n = 250/1627). However, 80.6% (n = 462/573) of femoral revisions were from two non-comparative studies. Among the five comparative studies, two included femoral or combined revisions with significantly more performed using the posterior approach. Three of the five comparative studies did not find the DAA protective against postoperative dislocation. The overall complication rate was 14.0%; periprosthetic femoral fracture (n = 106), dislocation (n = 80), and infection (n = 36) were most common. Fourteen studies reported patient-reported outcome measures, demonstrating consistent improvements following revision THA.
conclusionsCurrent data on revision DAA THA are limited due to their retrospective nature. They demonstrate the ability to safely perform acetabular and head-liner revisions in carefully selected patients. Comparative studies lack femoral revisions, show a propensity for femoral fractures, and exhibit selection bias. Higher-quality, comparative prospective studies are needed.
trial registrationPROSPERO: CRD4202236457.
Indexed as
Identifiers
39694949What 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.