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Is Limited Incision Better Than Standard Total Hip Arthroplasty? A Meta-analysis

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Clinical Orthopaedics and Related Research®

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A CORR Insights™ to this article was published on 24 January 2013

A CORR Insights to this article was published on 20 December 2012

Abstract

Background

The literature comparing limited incision and standard incision THAs is confusing regarding whether limited incision THA improves short-term recovery without compromising long-term durability and survival. Further, previously published meta-analyses cannot conclude that limited incision THA is better. With new data, we seek to discover if the answers now exist.

Purpose

We used meta-analysis to compare surgical and hospitalization data, clinical outcomes, and complication rates, and thus (1) confirm whether limited incision THA is at least comparable to standard incision THA; and (2) determine whether limited incision THA is an improvement over standard incision THA.

Methods

The PubMed database was searched using the terms “minimally”, “invasive”, and “total hip”. Inclusion was limited to studies directly comparing limited incision with standard incision THA and reporting effect sizes.

Results

We identified 418 articles. Of these 11 provided background information and 30 provided data (3548 THAs) for the systematic review. Limited incision THA was better than standard incision THA in four measures: length of hospitalization (6 versus 7 days), VAS pain at discharge (2 versus 4), blood loss (421 mL versus 494 mL), and the Harris hip score at 3 months postoperation (90 versus 84). There were no outcomes for which standard incision was better. There was no major difference in the rate of complications.

Conclusions

Short-term recovery favors limited incision over standard incision THA. The lack of consistent reporting for surgical outcomes, clinical outcomes, and complications continues to create difficulties when comparing limited and standard incision THAs.

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Authors and Affiliations

  1. Virginia Tech Carilion School of Medicine, No – 3 Riverside Circle – 1st Floor, Roanoke, VA, 24016, USA

    Joseph T. Moskal MD

  2. BENSOL Inc, Warsaw, IN, USA

    Susan G. Capps PhD

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  1. Joseph T. Moskal MD
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  2. Susan G. Capps PhD
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Correspondence to Joseph T. Moskal MD.

Additional information

One of the authors certifies that he (JTM), or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of $10,000–$100,000 from DePuy, a Johnson & Johnson Company (Warsaw, IN, USA); an amount of $10,000–$100,000 from Zimmer (Warsaw, IN, USA); and an amount of $10,000–$100,000 from Medtronic (Minneapolis, MN, USA). One of the authors certifies that she (SGC), or a member of her immediate family, has or may receive payments or benefits, during the study period, an amount of $10,000–$100,000 from DePuy, a Johnson & Johnson Company; and an amount of $10,000–$100,000 from J&P Moskal, Inc, (Roanoke, VA, USA).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved or waived approval for the reporting of this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at the Carilion School of Medicine Roanoke, VA, USA and at BENSOL Inc, Warsaw, IN, USA.

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Moskal, J.T., Capps, S.G. Is Limited Incision Better Than Standard Total Hip Arthroplasty? A Meta-analysis. Clin Orthop Relat Res 471, 1283–1294 (2013). https://doi.org/10.1007/s11999-012-2717-5

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  • DOI: https://doi.org/10.1007/s11999-012-2717-5

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