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Serum biomarkers for the assessment of muscle damage in various surgical approaches in primary total hip arthroplasty: a systematic review of comparative studies

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Abstract

Purpose

Using serum biomarkers, this systematic review assessed soft tissue injury following different total hip arthroplasty surgical approaches. The purposes were to determine if there is any advantage between the standard and minimal invasive approaches, and to compare tissue damage of the respective surgical approaches using biomarkers such as creatine kinase, myoglobin, c-reactive protein, erythrocyte sedimentation rate, skeletal troponin and interleukins.

Method

A search in Pubmed/MEDLINE, Scopus and Web of Science databases was conducted in October 2021 with the use of PRISMA guidelines. Search items were (“biomarkers” OR “markers” OR “tissue damage” OR “muscle damage”) AND “approach” AND (“total hip arthroplasty” OR “total hip replacement”). Inclusion criteria were prospective, randomized, controlled trials or prospective, comparative studies, comparing serum markers for muscle damage in two or more surgical approaches for primary total hip arthroplasty. Exclusion criteria were study protocols, case reports, systematic reviews, meta-analyses, studies in non-English language or without available full text, and studies not recording biomarkers of muscle damage.

Results

Initial search revealed 508 studies; after subtraction of duplicates, and exclusion criteria, 31 studies remained for analysis. No advantage between different approaches was found when evaluating biomarkers, and no specific biomarkers had a distinct role in tissue damage in total hip arthroplasty. Anterior and minimally invasive approaches were associated with lower values of soft tissue (creatine kinase) and inflammation (c-reactive protein) biomarkers compared to the standard approaches.

Conclusion

Measurement of serum biomarkers after primary total hip arthroplasty for the estimation of tissue damage has unclear or little clinical value.

Trial registration

PROSPERO Registration: CRD42022303959.

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Data availability

Data are available in a data repository.

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Authors and Affiliations

  1. Fourth Department of Orthopaedics, KAT Hospital, Athens, Greece

    Michael G. Sarantis & George A. Macheras

  2. Second Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Panagiotis I. Mandrekas, George C. Babis & Vasilios S. Nikolaou

  3. Department of Physical Therapy, Laboratory of Neuromuscular and Cardiovascular Study of Motion, University of West Attica, Athens, Greece

    Sophia Stasi

  4. Department of Biochemistry, KAT Hospital, Athens, Greece

    Konstantinos Makris

  5. First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Andreas F. Mavrogenis

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  1. Michael G. Sarantis
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Contributions

Conception: all authors; data collection: MGS, PIM, SS, KM, AFM, VSN; writing: MGS, AFM, VSN; critical review and revision: all authors.

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Correspondence to Andreas F. Mavrogenis.

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Sarantis, M.G., Mandrekas, P.I., Stasi, S. et al. Serum biomarkers for the assessment of muscle damage in various surgical approaches in primary total hip arthroplasty: a systematic review of comparative studies. International Orthopaedics (SICOT) 46, 1681–1692 (2022). https://doi.org/10.1007/s00264-022-05442-w

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