METHODS: PubMed, China National Knowledge Infrastructure, Epistemonikos, and Embase were searched until May 31, 2024. In a network meta-analysis, mean differences with 95% confidence intervals were calculated using the Hartung-Knapp-Sidik-Jonkman method and a fixed/random effects model for continuous outcomes, and odds ratios with 95% confidence intervals were calculated using the Mantel-Haenszel method and a fixed/random effects model for dichotomous outcomes.
RESULTS: The literature search identified a total of 9 randomized controlled trials on SuperPATH with 762 patients and 8 randomized controlled trials on DAA with 641 patients. In the overall ranking, SuperPATH was placed first, DAA second and CA third. SuperPATH HA was best in 7, second best in 2 and third best in 1 of the 10 outcome parameters. DAA HA was best in 2 and second best in 8 of the 10 outcome parameters. CA HA was best in 1 and third best in 9 of the 10 outcome parameters. In the indirect comparison between SuperPATH HA and DAA HA, SuperPATH HA had a 1.36 point lower visual analog scale at 2 to 7 days postoperatively and a 0.17 lower overall complication rate compared to DAA.
CONCLUSIONS: For the treatment of patients with femoral neck fractures, SuperPATH HA ranked first, DAA HA ranked second and CA HA ranked third. Based on the results, we recommend that trauma surgeons increase their use of minimally invasive hip HA techniques. It should be noted that SuperPATH HA had a significantly lower overall complication rate compared to DAA HA when the minimally invasive technique was chosen.
方法:PubMed,中国国家知识基础设施,认识论,和Embase被搜索到2024年5月31日。在网络荟萃分析中,使用Hartung-Knapp-Sidik-Jonkman方法和连续结局的固定/随机效应模型计算95%置信区间的平均差,使用Mantel-Haenszel方法和固定/随机效应模型计算比值比和95%置信区间。
结果:文献检索确定了9项关于SuperPATH的随机对照试验,762例患者,8项关于DAA的随机对照试验,641例患者。在整体排名中,SuperPATH被放在第一位,DAA第二,CA第三。SuperPATHHA在10个结果参数中的7个中最好,在2个中第二好,在1个中第三好。在10个结果参数中,DAAHA在2个中最好,在8个中次优。在10个结果参数中,CAHA在1个中最好,在9个中排名第三。在SuperPATHHA和DAAHA之间的间接比较中,与DAA相比,SuperPATHHA在术后2至7天的视觉模拟量表低1.36分,总并发症发生率低0.17。
结论:对于股骨颈骨折患者的治疗,SuperPATHHA排名第一,DAAHA排名第二,CAHA排名第三。根据结果,我们建议创伤外科医师增加使用微创髋关节HA技术.应当注意,当选择微创技术时,SuperPATHHA的总体并发症发生率明显低于DAAHA。