Comparing Hip Dislocation Rates in Total Hip Arthroplasty Direct Anterior Versus Posterior or Posterolateral Approaches: A Systematic Review
Abstract
Introduction: Total hip arthroplasty (THA) is a widely used treatment for hip osteoarthritis, providing significant pain relief and improved mobility. The choice of surgical approach, including posterior (PA), lateral (LA), and direct anterior (DAA), can influence the risk of dislocation. While the PA approach is the most commonly used, the DAA is gaining popularity due to its potential to reduce soft tissue trauma and dislocation risk. However, there is no consensus on the approach with the lowest dislocation rate. This study aims to systematically review dislocation rates between the direct anterior and posterior/posterolateral approaches in THA.
Methods: Following PRISMA guidelines, a comprehensive search of PubMed, the Cochrane Library, and Embase was conducted to identify high-quality studies published over the last 10 years. Studies included patients undergoing primary THA and reporting dislocation rates for DAA and posterior/posterolateral approaches. Data extraction and quality assessment were conducted independently by two reviewers. Eight studies met the inclusion criteria.
Results: Subgroup analyses revealed that most dislocations occurred in the posterior approach group. The DAA showed a lower, though not statistically significant, risk of dislocation. The risk varied based on patient characteristics, including surgeon experience, component size, and patient positioning. Approaches performed in a supine position (e.g., DAA) provided better control over…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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