Systematic review and meta-analysis on SuperPATH approach versus conventional approaches for hip arthroplasty

Aim: The SuperPATH approach has been in practice for almost a decade. There is no systematic review to date comparing the novel SuperPATH approach with conventional approaches. Therefore, it is important to conduct an up-to-date review to evaluate the benefits and drawbacks of the SuperPATH approach in comparison to widely accepted traditional approaches. Our primary aim was to compare the newer SuperPATH approach with the traditional approaches to the hip in terms of functional outcome and radiological parameters. We also aimed to identify any potential complications of the SuperPATH approach as it is a new surgical technique lacking any published sytematic reviews. Materials and methods: The review was conducted in accordance with the steps detailed in the Cochrane Handbook for Systematic reviews of intervention and will be reported bearing in mind the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PICO terms were independently searched in multiple databases. Studies that compared SuperPATH with traditional approaches were included in the analysis. Results: 7 studies including a total of 730 patients were available for final analysis. 3 studies were randomised control trials, 2 were prospective cohort studies and 2 were non-randomised case control studies. Patients in the SuperPATH group were discharged earlier (2 days difference in weighted mean). The operative time was 5 minutes longer (84.46 vs. 78.99) and there was a marginal decrease in blood loss (38 ml lesser) in the SuperPATH approach. VAS Score and HHS at the end of 1 year was comparable in both study groups. Cup abduction angle and anteversion angles were acceptable and comparable in both groups. Conclusions: The SuperPATH approach shows minimal improvement in length of hospital stay and blood loss with no significant improvement in pain or functional outcome score. There are no major complications reported and the radiological parameters are comparable.