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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2020

Open Access 01-12-2020 | Hip-TEP | Research article

Transosseous versus transmuscular repair of the posterior soft tissue in primary hip arthroplasty: a meta-analysis

Authors: Changjiao Sun, Xiaofei Zhang, Qi Ma, Ruiyong Du, Xu Cai, Huadong Yang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2020

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Abstract

Background

During the posterior approach, it has been shown that a significant reduction in dislocation rate can be achieved with the repair of the posterior soft tissue. However, no consensus exists about the best way to perform this repair. This review aimed to compare the transosseous with transmuscular repair of the posterior soft tissue in total hip arthroplasty (THA).

Methods

We conducted a meta-analysis to identify studies involving transosseous versus transmuscular repair of the posterior soft tissue in THA in electronic databases, including Web of Science, Embase, PubMed, Cochrane Controlled Trials Register, Cochrane Library, Highwire, CBM, CNKI, VIP, Wanfang database, up to July 2020. Finally, we identified 1417 patients (1481 hips) assessed in seven studies.

Results

Compared with transmuscular repair, transosseous repair resulted in less incidence of dislocation (P = 0.003), less blood loss during operation (P < 0.00001) and lower VAS score within 3 months (P = 0.02). There were no significant differences in terms of trochanteric fracture rate (P = 0.56), Harris hip score at 3 months (P = 0.35) and 6 months (P = 0.89), VAS score within 6 months (P = 0.53), and operation time (P = 0.70) between two groups.

Conclusion

The lower dislocation rate, less blood loss, and lower VAS scores after operation supported transosseous repair's superiority to transmuscular repair. Besides, no additional medical cost and operating time were associated with transosseous repair compared with transmuscular repair. Hence, we recommend that transosseous repair be chosen first by orthopedists when performing reconstruction of the posterior soft tissue in THA via a posterolateral approach. Given the relevant possible biases in our meta-analysis, we required more adequately powered and better-designed RCT studies with long-term follow-up to reach a firmer conclusion.
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Metadata
Title
Transosseous versus transmuscular repair of the posterior soft tissue in primary hip arthroplasty: a meta-analysis
Authors
Changjiao Sun
Xiaofei Zhang
Qi Ma
Ruiyong Du
Xu Cai
Huadong Yang
Publication date
01-12-2020
Publisher
BioMed Central
Keywords
Hip-TEP
Hip-TEP
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2020
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-020-02084-9

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