Comparison of Complications in Single-incision Minimally Invasive THA and Conventional THA

Abstract

The purpose of this meta-analysis was to investigate whether single-incision minimally invasive total hip arthroplasty (THA) is superior to conventional incision THA by comparing postoperative complication rates, Harris Hip Scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores. Randomized, controlled trials comparing single-incision minimally invasive THA and conventional THA were reviewed. The methodological quality of each randomized, controlled trial was assessed using the Physiotherapy Evidence Database (PEDro) scale (Centre for Evidence-based Physiotherapy, The George Institute for Global Health, New South Wales, Australia). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to determine the quality of the evidence. Fourteen studies involving 1254 patients (1329 hips) were included in the meta-analysis, comprising 659 single-incision minimally invasive THAs (mean patient age, 63.9 years) and 670 conventional incision THAs (mean patient age, 65.0 years). A funnel plot of postoperative complication rates showed that a slight publication bias existed in the study. According to the meta-analysis, no significant statistical difference was observed in complication rates in no more than 3 postoperative years (odds ratio=1.06; 95% confidence interval, 0.69 to 1.63; P=.79), in Harris Hip Scores in no more than 2 postoperative years (weighted mean difference=0.71; 95% confidence interval, -3.09 to 4.51; P=.71), and in WOMAC scores at 6 weeks postoperatively (weighted mean difference=-0.55; 95% confidence interval, -3.54 to 2.44; P=.72) between single-incision minimally invasive THA and conventional THA. Therefore, single-incision minimally invasive THA is not superior to conventional THA in early postoperative recovery, hip function, and complication rate.