Naomi Kobayashi1, Emi Kamono2, Kensuke Kameda2, Yohei Yukizawa2, Shu Takagawa2, Hideki Honda2, Yutaka Inaba3. 1. Department of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama, Japan. naomik58@aol.com. 2. Department of Orthopaedic Surgery, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama, Japan. 3. Department of Orthopaedic Surgery, Yokohama City University, Yokohama, Japan.
Abstract
INTRODUCTION: Although several surgical approaches, with or without capsular repair, can be used during total hip arthroplasty (THA), there is no clear evidence that capsular repair provides a clinical advantage post-surgery, regardless of surgical approach. This systematic review and meta-analysis evaluated whether capsular repair using various surgical approaches provides a clinical advantage over capsular resection post-THA. METHODS: This study was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 checklist for systematic reviews and meta-analyses. Multiple comprehensive literature searches were performed. Results were summarized qualitatively as meta-analysis of pooled odds ratios, and the standardized mean difference, with 95% confidence intervals for each group: capsular repair or capsular resection. A P value < 0.05 was considered statistically significant. Each study was evaluated for the risk of bias. Publication bias was also assessed. RESULTS: A total of 12 studies were included after screening and eligibility assessment. The odds ratio for hip dislocation after capsular repair was 0.14 (P < 0.00001). The standard mean difference of the Harris Hip Score (HHS) after capsular repair was 1.11 (P = 0.02). There were no significant differences between groups with respect to operation time (P = 0.79) and blood loss (P = 0.42). CONCLUSION: The current meta-analysis suggests that capsular repair leads to lower dislocation rates and a better HHS after THA.
INTRODUCTION: Although several surgical approaches, with or without capsular repair, can be used during total hip arthroplasty (THA), there is no clear evidence that capsular repair provides a clinical advantage post-surgery, regardless of surgical approach. This systematic review and meta-analysis evaluated whether capsular repair using various surgical approaches provides a clinical advantage over capsular resection post-THA. METHODS: This study was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 checklist for systematic reviews and meta-analyses. Multiple comprehensive literature searches were performed. Results were summarized qualitatively as meta-analysis of pooled odds ratios, and the standardized mean difference, with 95% confidence intervals for each group: capsular repair or capsular resection. A P value < 0.05 was considered statistically significant. Each study was evaluated for the risk of bias. Publication bias was also assessed. RESULTS: A total of 12 studies were included after screening and eligibility assessment. The odds ratio for hip dislocation after capsular repair was 0.14 (P < 0.00001). The standard mean difference of the Harris Hip Score (HHS) after capsular repair was 1.11 (P = 0.02). There were no significant differences between groups with respect to operation time (P = 0.79) and blood loss (P = 0.42). CONCLUSION: The current meta-analysis suggests that capsular repair leads to lower dislocation rates and a better HHS after THA.
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