全髋关节置换术经直接前方入路与后方入路临床疗效的Meta分析

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Abstract Objective To performed a systematic review and meta-analysis to assess the outcome of direct anterior approach (DAA) and posterior approach (PA) for total hip arthroplasty.Methods Published studies comparing DAA and PA for THA were searched in major databases from the inception of each database until October 2017 without language restriction.Eligible studies were selected according to inclusion and exclution criteria.The data were extracted and the quality of included studies was evaluated by two reviewers.Meta analysis was performed using RevMan 5.3 software.Results A total of 10 prospective comparative studies (7 randomized) with patients treated with DAA (n＝407) or PA (n＝405) were included.The result of Meta-analysis showed that DAA was superior to PA in early postoperative function rehabilitation and acticities and the patients in DAA group had less pain than these in PA after operation.The incidence of lateral femoral cutaneous nerve injury and the percentage of acetabular cups placed within the Lewinnek safe zone were higher in DAA group than PA group.There was no significant difference in the incidence of intraoperative fractures，postoperative dislocation，incision complications，heterotopic ossification and groin pain between the two groups.Neither were the operation time，length of hospital stay，intraoperative blood less or angle of acetabular cup anteversion angle of cup inclination. Conclusion The early recovery of DAA for THA is better than that of PA after operation.Postoperative pain in DAA group is less，but the incidence of lateral femoral cutaneous nerve injury is high.

Key words： surgical approach direct anterior approach posterior approach total hip arthroplast

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