Nerve palsy, dislocation and revision rate among the approaches for total hip arthroplasty: a Bayesian network meta-analysis

Musculoskelet Surg. 2021 Apr;105(1):1-15. doi: 10.1007/s12306-020-00662-y. Epub 2020 May 5.


Background: Total hip arthroplasty (THA) is one of the most performed intervention in orthopaedics surgery. Currently, there is no unanimous approval concerning the best approach for THA in terms of nerve palsies, dislocations and further revisions. Hence, a Bayesian network meta-analysis was conducted.

Methods: The present study was conducted according to the PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of healthcare interventions. The literature search was performed in September 2019. The NMA was performed through the STATA Software/MP routine for Bayesian hierarchical random-effects model analysis.

Results: Data from 10,675 THA were collected. The mean follow-up was 10 months. The anterior approach reported the lowest risk to incur a post-operative dislocation (overall inconsistency P = 0.99). The posterolateral approach reported the lowest risk to incur a nerve palsy (overall inconsistency P = 0.77). The funnel plot revealed a low risk of publication bias. The lateral approach was found to have the lowest risk of resulting in a revision surgery (overall inconsistency P = 0.90).

Conclusion: According to our network comparisons, the posterolateral approach for THA represent the favourable exposure with regards to nerve palsy, further dislocations and revision surgeries.

Keywords: Approaches; Bayesian network meta-analysis; Total hip arthroplasty.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Arthroplasty, Replacement, Hip*
  • Bayes Theorem
  • Hip Dislocation* / epidemiology
  • Hip Dislocation* / surgery
  • Hip Prosthesis*
  • Humans
  • Network Meta-Analysis
  • Paralysis / epidemiology
  • Paralysis / etiology
  • Reoperation
  • Retrospective Studies