A systematic review comparing the cost-effectiveness of the direct anterior, posterior, and straight lateral approach in total hip arthroplasty
Background: Total hip arthroplasty is a reliable option to treat osteoarthritis. It reduces pain, increases quality of life, and restores function. The direct anterior approach (DAA), posterior approach (PA), and straight lateral approach (SLA) are mostly used. This systematic review evaluates curre...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-06-01
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| Series: | EFORT Open Reviews |
| Subjects: | |
| Online Access: | https://eor.bioscientifica.com/view/journals/eor/8/6/EOR-22-0108.xml |
| _version_ | 1827926250861101056 |
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| author | Julia E J W Geilen Sem M M Hermans Ruud Droeghaag Martijn G M Schotanus Emil H van Haaren Wouter L W van Hemert |
| author_facet | Julia E J W Geilen Sem M M Hermans Ruud Droeghaag Martijn G M Schotanus Emil H van Haaren Wouter L W van Hemert |
| author_sort | Julia E J W Geilen |
| collection | DOAJ |
| description | Background: Total hip arthroplasty is a reliable option to treat osteoarthritis. It reduces pain, increases quality of life, and restores function. The direct anterior approach (DAA), posterior approach (PA), and straight lateral approach (SLA) are mostly used. This systematic review evaluates current literature about costs and cost-effectiveness of DAA, PA, and SLA.
Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic search, registered in the PROSPERO database (registration number: CRD42021237427), was conducted of databases PubMed, CINAHL, EMBASE, Cochrane, Clinical Trials, Current Controlled Trials, ClinicalTrials.gov, NHS Centre for Review and Dissemination, Econlit, and Web of Science. Eligible studies were randomized controlled trials (RCTs) or comparative cohort studies reporting or comparing costs or cost-effectiveness of either approach as the primary outcome. The risk of bias (RoB) was assessed. For comparison, all costs were converted to American Dollars (reference year 2016).
Results: Six systematic review studies were included. RoB ranged from low to high, the level of evidence ranged from 2 to 4, and methodological quality was moderate. Costs ranged from $5313.85 to $15 859.00 (direct) and $1921.00 to $6364.30 (indirect) in DAA. From $5158.46 to $12 344.47 (direct) to $2265.70 to $5566.01 (indirect) for PA and from $3265.62 to $8501.81 (direct) and $2280.16 (indirect) for SLA. Due to heterogeneity of included costs, they were not directly comparable. Solid data about cost-effectiveness cannot be presented.
Conclusions: Due to limited and heterogenous evidence about costs and cost-effectiveness, the effect of these in surgical approach is unknown. Further well-powered research to make undisputed conclusions is needed. |
| first_indexed | 2024-03-13T05:36:29Z |
| format | Article |
| id | doaj.art-5484d5a41b0c4c798039771007378375 |
| institution | Directory Open Access Journal |
| issn | 2058-5241 |
| language | English |
| last_indexed | 2024-03-13T05:36:29Z |
| publishDate | 2023-06-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | EFORT Open Reviews |
| spelling | doaj.art-5484d5a41b0c4c7980397710073783752023-06-14T06:58:30ZengBioscientificaEFORT Open Reviews2058-52412023-06-0186443450https://doi.org/10.1530/EOR-22-0108A systematic review comparing the cost-effectiveness of the direct anterior, posterior, and straight lateral approach in total hip arthroplastyJulia E J W Geilen0Sem M M Hermans1Ruud Droeghaag2Martijn G M Schotanus3Emil H van Haaren4Wouter L W van Hemert5Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen and Heerlen, the NetherlandsDepartment of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen and Heerlen, the Netherlands; Care and Public Health Research Institute (CAPHRI) Maastricht University, Maastricht, the Netherlands Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen and Heerlen, the Netherlands; Care and Public Health Research Institute (CAPHRI) Maastricht University, Maastricht, the Netherlands Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen and Heerlen, the Netherlands; Care and Public Health Research Institute (CAPHRI) Maastricht University, Maastricht, the Netherlands Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen and Heerlen, the NetherlandsDepartment of Orthopaedic Surgery and Traumatology, Zuyderland Medical Center, Sittard-Geleen and Heerlen, the NetherlandsBackground: Total hip arthroplasty is a reliable option to treat osteoarthritis. It reduces pain, increases quality of life, and restores function. The direct anterior approach (DAA), posterior approach (PA), and straight lateral approach (SLA) are mostly used. This systematic review evaluates current literature about costs and cost-effectiveness of DAA, PA, and SLA. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) systematic search, registered in the PROSPERO database (registration number: CRD42021237427), was conducted of databases PubMed, CINAHL, EMBASE, Cochrane, Clinical Trials, Current Controlled Trials, ClinicalTrials.gov, NHS Centre for Review and Dissemination, Econlit, and Web of Science. Eligible studies were randomized controlled trials (RCTs) or comparative cohort studies reporting or comparing costs or cost-effectiveness of either approach as the primary outcome. The risk of bias (RoB) was assessed. For comparison, all costs were converted to American Dollars (reference year 2016). Results: Six systematic review studies were included. RoB ranged from low to high, the level of evidence ranged from 2 to 4, and methodological quality was moderate. Costs ranged from $5313.85 to $15 859.00 (direct) and $1921.00 to $6364.30 (indirect) in DAA. From $5158.46 to $12 344.47 (direct) to $2265.70 to $5566.01 (indirect) for PA and from $3265.62 to $8501.81 (direct) and $2280.16 (indirect) for SLA. Due to heterogeneity of included costs, they were not directly comparable. Solid data about cost-effectiveness cannot be presented. Conclusions: Due to limited and heterogenous evidence about costs and cost-effectiveness, the effect of these in surgical approach is unknown. Further well-powered research to make undisputed conclusions is needed.https://eor.bioscientifica.com/view/journals/eor/8/6/EOR-22-0108.xmltotal hip arthroplastydirect anterior approachposterior approachstraight lateral approachcostscost-effectiveness |
| spellingShingle | Julia E J W Geilen Sem M M Hermans Ruud Droeghaag Martijn G M Schotanus Emil H van Haaren Wouter L W van Hemert A systematic review comparing the cost-effectiveness of the direct anterior, posterior, and straight lateral approach in total hip arthroplasty EFORT Open Reviews total hip arthroplasty direct anterior approach posterior approach straight lateral approach costs cost-effectiveness |
| title | A systematic review comparing the cost-effectiveness of the direct anterior, posterior, and straight lateral approach in total hip arthroplasty |
| title_full | A systematic review comparing the cost-effectiveness of the direct anterior, posterior, and straight lateral approach in total hip arthroplasty |
| title_fullStr | A systematic review comparing the cost-effectiveness of the direct anterior, posterior, and straight lateral approach in total hip arthroplasty |
| title_full_unstemmed | A systematic review comparing the cost-effectiveness of the direct anterior, posterior, and straight lateral approach in total hip arthroplasty |
| title_short | A systematic review comparing the cost-effectiveness of the direct anterior, posterior, and straight lateral approach in total hip arthroplasty |
| title_sort | systematic review comparing the cost effectiveness of the direct anterior posterior and straight lateral approach in total hip arthroplasty |
| topic | total hip arthroplasty direct anterior approach posterior approach straight lateral approach costs cost-effectiveness |
| url | https://eor.bioscientifica.com/view/journals/eor/8/6/EOR-22-0108.xml |
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