Which approach of total hip arthroplasty is the best efficacy and least complication?

Table 1 Characteristics of the 28 included meta-analysis studies

Ref.	Last search	Study design	Number of included studies	Sample size	Intervention	Reference	Outcome
Putananon et al[37], 2018	February, 2017	RCT	14	1201	PA/LA/DAA/PA2	PA	HHS, VAS, complications
Higgins et al[6], 2015	February, 2014	RCT & nRCT	17	2302	PA/DAA	PA	HHS, VAS, blood loss, intra-operative fracture, operative time, length of hospital stay, dislocation
Miller et al[34], 2018	June, 2017	RCT & nRCT	13	1044	PA/DAA	PA	HHS, dislocation, intra-operative fracture, wound infection
Wang et al[44], 2018	June, 2018	RCT	9	754	PA/DAA	PA	HHS, VAS, incision length, operative time, length of hospital stay, operative blood loss, intra-operative fracture, dislocation
Miller et al[35], 2018	June, 2017	RCT	7	609	PA/DAA	PA	Incision length, length of hospital stay, operative time, operative blood loss, pain score, complication
Kucukdurmaz et al[30], 2019	January, 2018	RCT & nRCT	17/1	1543	PA/LA/DAA	PA	HHS, operative time, incision length, VAS, neurapraxia, intra-operative fracture, wound infection, dislocation
Jia et al[28], 2019	August, 2016	RCT & nRCT	4/16	7377	PA/DAA	PA	HHS, length of hospital stay, operative time, VAS, dislocation, neurapraxia, intra-operative fracture
Wang et al[43], 2019	October, 2018	RCT	5	475	LA/DAA	LA	HHS, VAS, operative time, operative blood loss, length of hospital stay, complication
Migliorini et al[32], 2021	September, 2019	RCT & nRCT	20/39	10675	PA/LA/DAA	PA	Dislocation, nerve injury, revision
Migliorini et al[33], 2020	October, 2019	RCT & nRCT	13/23	4383	PA/LA/DAA	PA	Length of hospital stay, operative time, operative blood loss
Cha et al[22], 2020	October, 2019	RCT	8	673	PA/LA/DAA	PA	Operative time, Operative blood loss
Peng et al[36], 2020	November, 2019	RCT	7	600	PA/DAA	PA	HHS, VAS, operative time, operative blood loss, length of hospital stay, incision length
Docter et al[24], 2020	June, 2019	RCT & nRCT	19/50	283036	PA/LA/DAA	PA	Dislocation, intra-operative fracture, infection
Yang et al[45], 2020	June, 2019	RCT	11	932	PA/DAA	PA	VAS, neurapraxia, intra-operative fracture, infection, dislocation, operative time, operative blood loss, length of hospital stay
Chen et al[23], 2020	2020	RCT & nRCT	4 /14	34873	PA/DAA	PA	HHS, VAS, operative time, operative blood loss, length of hospital stay, dislocation, intra-operative fracture
Sun et al[42], 2021	June, 2019	RCT & nRCT	3 /6	22698	PA/DAA	PA	HHS, operative time, operative blood loss, length of hospital stay, complication
Awad et al[21], 2021	2021	RCT & nRCT	7/22	8576	PA/DAA	PA	HHS, operative time, operative blood loss, length of hospital stay, complication
Huerfano et al[27], 2021	2021	RCT & nRCT	5/20	7172	PA/DAA/	PA	Dislocation
Gazendam et al[25], 2022	2021	RCT	25	2339	PA/LA/ALA/DAA	PA	HHS, VAS, length of hospital stay, complication
Ge et al[26], 2021	2021	RCT & nRCT	3/3	526	DSA/SuperPath/PA	PA	HHS, operative time, operative blood loss, incision length, VAS, length of hospital stay
Joseph et al[29], 2023	2022	RCT	7	730	DSA/SuperPath/PA	PA	HHS, operative time, operative blood loss, incision length, VAS, length of hospital stay, complication
Lazaru et al[31], 2021	2021	RCT	9	998	DAA/PA	PA	HHS, operative time, operative blood loss, incision length, VAS
O’connor et al[105], 2021	2021	No RCT	15	1872	DAA/non-DAA	PA, ALA, LA	Infection
Ramadanov et al[39], 2021	2021	RCT	16	1392	DSA/SuperPath/DAA/PA	PA	HHS, operative time, operative blood loss, incision length, VAS
Ramadanov et al[40], 2021	2021	RCT	24	2074	DSA/SuperPath/DAA/PA	PA	HHS, operative time, operative blood loss, incision length, VAS, complication
Ramadanov et al[41], 2022	2022	RCT	20	1501	SuperPath/DAA/PA	PA	HHS, operative time, operative blood loss, incision length
Ramadanov et al[38], 2022	2022	RCT	14	1021	SuperPath/PA	PA	HHS, operative time, operative blood loss, incision length, VAS, complication
Zhou et al[46], 2022	2022	RCT	15	1450	DAA/PA/LA	PA, LA	HHS, operative time, length of hospital stay, complication
Ang et al[20], 2023	2023	RCT	24	2010	DAA/LA/PA	PA	HHS, operative time, length of hospital stay, complication

RCT: Randomized controlled trial; nRCT: Not randomized controlled trial; HHS: Harris hip score; VAS: Visual analog scale; PA: Posterior approach; LA: Lateral approach; DAA: Direct anterior approach; 2-incision: 2 incisions approach; LMIS: Mini-lateral approach; ALA: Anterolateral approach; DSA/SuperPath: Direct superior approach or Supercapsular percutaneously-assisted total hip.