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Implant positioning among the surgical approaches for total hip arthroplasty: a Bayesian network meta-analysis

  • Hip Arthroplasty
  • Published:
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Abstract

Introduction

Although there is anatomical individuality among patients, some standardized requirements for component orientation for total hip arthroplasty (THA) exist. To date, no study has compared implant positioning using a network meta-analysis (NMA). Hence, the purpose of this study was to perform a NMA comparing implant positioning among the various approaches for THA.

Methods

This study was conducted according to the PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions. All randomized (RCT) and non-randomized (nRCT) clinical trials comparing two or more different approaches for THA were considered for inclusion. For the statistical analysis, the STATA Software/ MP, Version 14.1 (Stata Corporation, College Station, Texas, USA) was used. The NMA was performed through a Stata routine for Bayesian hierarchical random-effects model analysis.

Results

We enrolled in the present study, a total of 4060 patients, with a mean of 17.84 ± 16.41 months follow-up. The patient baseline data were very homogeneous across the groups concerning age (P = 0.91), sex (P = 0.52), and BMI (P = 0.83). Concerning the cup anteversion, the anterolateral approach reported the value closest to the reference value. The test for overall inconsistency, however, was not statistically significant (P = 0.30). Concerning cup inclination, the lateral approach reported the value closest to the reference value. The test for overall inconsistency was statistically significant (P = 0.01).

Conclusion

The anterolateral approach for total hip arthroplasty detected the best femoral stem alignment and cup anteversion. Data concerning cup inclination detected no sufficient transitivity to draw consistent conclusions.

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Authors and Affiliations

  1. Department of Orthopaedics, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074, Aachen, Germany

    Filippo Migliorini, Jörg Eschweiler, Björn Rath, Arne Driessen & Markus Tingart

  2. Department of Orthopaedics, David Geffen School of Medicine At UCLA, Suite 755, Los Angeles, CA, 90095, USA

    Andromahi Trivellas

  3. Fondazione Pisana Per La Scienza, Via Ferruccio Giovannini 13, 56017, Pisa, Italy

    Paolo Arentini

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  1. Filippo Migliorini
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Migliorini, F., Eschweiler, J., Trivellas, A. et al. Implant positioning among the surgical approaches for total hip arthroplasty: a Bayesian network meta-analysis. Arch Orthop Trauma Surg 140, 1115–1124 (2020). https://doi.org/10.1007/s00402-020-03448-w

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