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

Table 4 Network meta-analysis results of secondary outcomes

Risk ratio/Unstandardized mean difference (95%CI)
	PA	LA	DAA	2 incisions	LMIS	DSA/SuperPath
Operative time
PA	[98.6; 93.2]	10.38 (2.04, 18.71)	15.38 (8.64, 22.12)	21.00 (-4.27, 46.27)	23.86 (4.25, 43.47)	18.74 (9.69, 27.79)
LA	-10.38 (-18.71, -2.04)	[70.7; 0.7]	5.01 (-2.66, 12.68)	10.62 (-15.99, 37.24)	13.49 (-4.26, 31.23)	8.36 (-3.12, 19.84)
DAA	-15.38 (-22.12, -8.64)	-5.01 (-12.68, 2.66)	[46.0; 0.0]	5.62 (-20.54, 31.78)	8.48 (-10.86, 27.81)	3.35 (-7.58, 14.29)
2-incision	-21.00 (-46.27, 4.27)	-10.62 (-37.24, 15.99)	-5.62 (-31.78, 20.54)	[33.8; 5.3]	2.86 (-29.13, 34.85)	-2.26 (-29.11, 24.58)
LMIS	-23.86 (-43.47, -4.25)	-13.49 (-31.23, 4.26)	-8.48 (-27.81, 10.86)	-2.86 (-34.85, 29.13)	[19.6; 0.8]	-5.12 (-26.26, 16.01)
DSA/SuperPath	-18.74 (-27.79, -9.69)	-8.36 (-19.84, 3.12)	-3.35 (-14.29, 7.58)	2.26 (-24.58, 29.11)	5.12 (-16.01, 26.26)	[31.4; 0.0]
Length of hospital stay
PA	[45.5; 0.0]	0.52 (-0.36, 1.39)	-0.21 (-0.84, 0.43)	0.11 (-1.29, 1.51)	0.32 (-2.12, 2.76)	-1.56 (-2.44, -0.69)
LA	-0.52 (-1.39, 0.36)	[16.9; 0.0]	-0.72 (-1.52, 0.07)	-0.41 (-1.92, 1.10)	-0.20 (-2.48, 2.08)	-2.08 (-3.12, -1.04)
DAA	0.21 (-0.43, 0.84)	0.72 (-0.07, 1.52)	[61.3; 0.7]	0.31 (-1.17, 1.80)	0.52 (-1.89, 2.94)	-1.36 (-2.36, -0.35)
2-incision	-0.11 (-1.51, 1.29)	0.41 (-1.10, 1.92)	-0.31 (-1.80, 1.17)	[42.6; 3.0]	0.21 (-2.52, 2.94)	-1.67 (-3.28, -0.06)
LMIS	-0.32 (-2.76, 2.12)	0.20 (-2.08, 2.48)	-0.52 (-2.94, 1.89)	-0.21 (-2.94, 2.52)	[35.8; 6.3]	-1.88 (-4.38, 0.62)
DSA/SuperPath	1.56 (0.69, 2.44)	2.08 (1.04, 3.12)	1.36 (0.35, 2.36)	1.67 (0.06, 3.28)	1.88 (-0.62, 4.38)	[97.9; 90.0]
Incision length
PA	[4.0; 0.0]	-1.53 (-3.86, 0.81)	-2.54 (-4.64, -0.45)	NR	-3.42 (-7.99, 1.16)	-5.15 (-7.29, -3.01)
LA	1.53 (-0.81, 3.86)	[31.1; 0.0]	-1.02 (-3.00, 0.96)	NR	-1.89 (-5.82, 2.04)	-3.62 (-6.52, -0.72)
DAA	2.54 (0.45, 4.64)	1.02 (-0.96, 3.00)	[55.4; 1.8]	NR	-0.87 (-5.27, 3.53)	-2.60 (-5.45, 0.24)
2-incision	NR	NR	NR	NR	NR	NR
LMIS	3.42 (-1.16, 7.99)	1.89 (-2.04, 5.82)	0.87 (-3.53, 5.27)	NR	[66.5; 24.5]	-1.73 (-6.62, 3.16)
DSA/SuperPath	5.15 (3.01, 7.29)	3.62 (0.72, 6.52)	2.60 (-0.24, 5.45)	NR	1.73 (-3.16, 6.62)	[92.9; 73.7]
Operative blood loss
PA	[61.6; 10.7]	-25.66 (-117.26, 65.95)	23.03 (-56.18, 102.24)	46.00 (-185.02, 277.02)	59.67 (-177.38, 296.72)	23.02 (-56.58, 102.62)
LA	25.66 (-65.95, 117.26)	[75.9; 35.1]	48.69 (-47.77, 145.15)	71.66 (-176.86, 320.18)	85.33 (-133.30, 303.96)	48.68 (-62.19, 159.55)
DAA	-23.03 (-102.24, 56.18)	-48.69 (-145.15, 47.77)	[44.0; 5.6]	22.97 (-221.26, 267.19)	36.64 (-202.33, 275.61)	-0.01 (-108.84, 108.82)
2-incision	-46.00 (-277.02, 185.02)	-71.66 (-320.18, 176.86)	-22.97 (-267.19, 221.26)	[41.9; 24.3]	13.67 (-317.33, 344.68)	-22.98 (-267.33, 221.37)
LMIS	-59.67 (-296.72, 177.38)	-85.33 (-303.96, 133.30)	-36.64 (-275.61, 202.33)	-13.67 (-344.68, 317.33)	[34.4; 17.5]	-36.65 (-281.79, 208.49)
DSA/SuperPath	-23.02 (-102.62, 56.58)	-48.68 (-159.55, 62.19)	0.01 (-108.82, 108.84)	22.98 (-221.37, 267.33)	36.65 (-208.49, 281.79)	[42.2; 6.8]
Wound complication
PA	[70.0; 16.2]	2.26 (0.72, 7.06)	1.31 (0.59, 2.88)	0.80 (0.04, 18.03)	5.45 (0.60, 49.61)	1.00 (0.15, 6.79)
LA	0.44 (0.14, 1.38)	[31.0; 0.9]	0.58 (0.18, 1.87)	0.36 (0.02, 7.11)	2.41 (0.36, 16.00)	0.44 (0.05, 4.11)
DAA	0.77 (0.35, 1.69)	1.73 (0.53, 5.62)	[54.8; 5.2]	0.62 (0.03, 14.29)	4.18 (0.45, 38.77)	0.77 (0.10, 6.09)
2-incision	1.24 (0.06, 27.95)	2.81 (0.14, 56.24)	1.62 (0.07, 37.72)	[68.8; 46.2]	6.79 (0.20, 234.54)	1.24 (0.03, 48.08)
LMIS	0.18 (0.02, 1.67)	0.41 (0.06, 2.75)	0.24 (0.03, 2.22)	0.15 (0.00, 5.09)	[12.5; 1.3]	0.18 (0.01, 3.41)
DSA/SuperPath	1.00 (0.15, 6.79)	2.26 (0.24, 20.99)	1.31 (0.16, 10.38)	0.80 (0.02, 31.03)	5.45 (0.29, 101.44)	[62.8; 30.2]
Nerve injury
PA	[79.7; 25.6]	2.97 (0.89, 9.97)	9.82 (3.06, 31.58)	18.97 (2.41, 149.62)	1.08 (0.11, 10.20)	1.00 (0.02, 49.35)
LA	0.34 (0.10, 1.13)	[49.4; 0.5]	3.30 (1.22, 8.94)	6.38 (0.81, 50.31)	0.36 (0.05, 2.41)	0.34 (0.01, 19.93)
DAA	0.10 (0.03, 0.33)	0.30 (0.11, 0.82)	[17.9; 0.0]	1.93 (0.22, 16.92)	0.11 (0.01, 0.93)	0.10 (0.00, 5.96)
2-incision	0.05 (0.01, 0.42)	0.16 (0.02, 1.24)	0.52 (0.06, 4.54)	[9.0; 0.2]	0.06 (0.00, 0.94)	0.05 (0.00, 4.35)
LMIS	0.93 (0.10, 8.81)	2.76 (0.41, 18.42)	9.13 (1.07, 77.77)	17.63 (1.07, 291.08)	[75.1; 31.9]	0.93 (0.01, 83.77)
DSA/SuperPath	1.00 (0.02, 49.35)	2.97 (0.05, 176.30)	9.82 (0.17, 575.31)	18.97 (0.23, 1564.11)	1.08 (0.01, 97.00)	[69.0; 41.8]

Values are the risk ratio (95% confidence interval; 95%CI) of dichotomous outcomes (wound complication and nerve injury) or the mean difference (95%CI) of continuous outcomes [operative time (min), length of hospital stay (d), incision length (cm), operative blood loss (mL) comparing surgical interventions in column with surgical intervention in row (reference)]; Values of diagonal line in square brackets are surface under the cumulative ranking curve area and probability of being best surgical approaches (lowest operative time, length of hospital stay, incision length, operative blood loss and low risk of wound complication, nerve injury). PA: Posterior approach; LA: Lateral approach; DAA: Direct anterior approach; 2-incision: 2 incisions approach; LMIS: Mini-lateral approach; DSA/SuperPath: Direct superior approach or Supercapsular percutaneously-assisted total hip; NR: Not report.