Meta-Analysis Reveals Improved Outcomes in the Immediate Post-op Period Compared to the Posterior Approach
JANUARY 29, 2018 Warsaw, Indiana – DePuy Synthes*, part of the Johnson & Johnson Medical Devices Companies, today announced the first systematic review of prospective studies comparing postoperative outcomes through 90 days of Anterior Approach versus Posterior Approach in primary total hip arthroplasty (THA). The paper, published in The Journal of Arthroplasty, concludes that the Anterior Approach can provide a significant increase in hip function and reduction in pain and narcotics usage compared to Posterior Approach. In addition, the study showed no statistical differences in complication rates between the Anterior Approach and Posterior Approach through 90 days.
Previous comparative reviews of Anterior Approach versus Posterior Approach have predominantly relied on data from retrospective studies. For this meta-analysis, a total of 13 prospective comparative studies (including 7 randomized studies) published between 2006 and 2017 of more than 1,000 patients treated with Anterior Approach or Posterior Approach were included. Focused on perioperative outcomes, the meta-analysis attempted to address each component of the Comprehensive Care for Joint Replacement (CJR) model, which includes complication rate, patient satisfaction, and pain management over a 90-day period. The research was performed by Drs. Friedrich Boettner, Joseph S. Gondusky, and Atul F. Kamath** and well-known meta-analyst Dr. Larry E. Miller. Co-authors of the paper included Samir Bhattacharyya, PhD, MS, MSc, U.S. Head for Health Economics and Market Access (HEMA) DePuy Synthes and Dr. John Wright, Medical Leader DePuy Synthes.
“Our goal with this research was to rigorously evaluate outcomes of Anterior Approach and Posterior Approach from the highest quality prospective studies performed to date,” said lead author Dr. Miller. “We found that THA using the Anterior Approach provided clinically important benefits to patients compared to Posterior Approach over 90 days follow-up.”
The move toward the Anterior Approach is increasing as seen in a 2016 American Association of Hip and Knee Surgeons (AAHKS) survey where 34 percent of surgeons reported they were performing the Anterior Approach compared to 26 percent in a 2015 AAHKS survey. In an effort to gather additional data on this trend, DePuy Synthes, which funded this study, sought to understand the short-term benefits of the Anterior Approach as surgeons look for options in treating their patients. DePuy Synthes has spent more than a decade supporting healthcare providers who are interested in adding the Anterior Approach to their practices through professional education and training, and bringing enabling technologies to market.
“While the Posterior Approach is still the most widely used technique worldwide, we see growing interest in the Anterior Approach,” said Bhattacharyya. “This study builds on the mounting evidence that the Anterior Approach supports the goals of improving outcomes, optimizing the patient experience and reducing the overall cost of care.”;
The study, “Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review with Meta-Analysis,” is available online and will appear mid-2018 in the Journal of Arthroplasty.
About DePuy Synthes
DePuy Synthes, part of the Johnson & Johnson Medical Devices Companies***, provides one of the most comprehensive orthopaedics portfolios in the world. DePuy Synthes solutions, in specialties including joint reconstruction, trauma, craniomaxillofacial, spinal surgery and sports medicine, are designed to advance patient care while delivering clinical and economic value to health care systems worldwide. For more information, visit www.depuysynthes.com.
*DePuy Synthes represents the products and services of DePuy Synthes, Inc. and its affiliates.
**Drs. Friedrich Boettner, Joseph S. Gondusky, and Atul F. Kamath are consultants to DePuy Synthes Joint Reconstruction.
***The Johnson & Johnson Medical Devices Companies comprise the surgery, orthopaedics, and cardiovascular businesses within Johnson & Johnson's Medical Devices segment.
©DePuy Synthes 2018. All rights reserved.