Strong evidence was found for a decrease in operative time and intraoperative blood loss for MIS THA , with no difference in complication rates and risk for acetabular outliers .
Strong evidence exists that there is no difference in physical functioning , measured either by question naires or by gait analysis .
Moderate evidence was found for a shorter length of hospital stay after MIS THA .
Conflicting evidence was found for a positive effect of MIS THA on pain in the early postoperative period , but that effect diminished after three months postoperatively .
Strong evidence was found for an increase in operative time for CAS THA , and limited evidence was found for a decrease in intraoperative blood loss .
Furthermore , strong evidence was found for no difference in complication rates , as well as for a significantly lower risk for acetabular outliers .
Conclusions The results indicate that MIS THA is a safe surgical procedure , without increases in operative time , blood loss , operative complication rates and component malposition rates .
However , the beneficial effect of MIS THA on functional recovery has to be proven .
The results also indicate that CAS THA , though result ing in an increase in operative time , may have a positive effect on operative blood loss and operative complication rates .
More importantly , the use of CAS results in better positioning of acetabular component of the prosthesis
Background Both minimally invasive surgery ( MIS ) and computer-assisted surgery ( CAS ) for total hip arthroplasty ( THA ) have gained popularity in recent years .
We conducted a qualitative and systematic review to assess the effectiveness of MIS , CAS and computer-assisted MIS for THA .
Does a "Level I Evidence" rating imply high quality of reporting in orthopaedic randomised controlled trials?
Background The Levels of Evidence Rating System is widely believed to categorize studies by quality , with Level I studies representing the highest quality evidence . We aim ed to determine the reporting quality of R and  omised Controlled Trials ( RCTs ) published in the most frequently cited general orthopaedic journals . Methods Two assessors identified orthopaedic journals that reported a level of evidence rating in their abstract s from January 2003 to December 2004 by search ing the instructions for authors of the highest impact general orthopaedic journals . Based upon a priori eligibility criteria , two assessors h and search ed all issues of the eligible journal from 2003–2004 for RCTs . The assessors extracted the demographic information and the evidence rating from each included RCT and scored the quality of reporting using the reporting quality assessment tool , which was developed by the Cochrane Bone , Joint and Muscle Trauma Group . Scores were conducted in duplicate , and we reached a consensus for any disagreements . We examined the correlation between the level of evidence rating and the Cochrane reporting quality score . Results We found that only the Journal of Bone  and Joint  Surgery –  American Volume ( JBJS-A ) used a level of evidence rating from 2003 to 2004 . We identified 938 publications in the JBJS-A from January 2003 to December 2004 . Of these publications , 32 ( 3.4 % ) were RCTs that fit the inclusion criteria . The 32 RCTs included a total of 3543 patients , with sample sizes ranging from 17 to 514 patients . Despite being labelled as the highest level of evidence ( Level 1 and Level II evidence ) , these studies had low Cochrane reporting quality scores among individual method ological safeguards . The Cochrane reporting quality scores did not differ significantly between Level I and Level II studies . Correlations varied from 0.0 to 0.2 across the 12 items of the Cochrane reporting quality assessment tool ( p > 0.05 ) . Among items closely corresponding to the Levels of Evidence Rating System criteria assessors achieved substantial agreement ( ICC = 0.80 , 95%CI:0.60 to 0.90 ) . Conclusion Our findings suggest that readers should not assume that 1 ) studies labelled as Level I have high reporting quality and 2 ) Level I studies have better reporting quality than Level II studies . One should address method ological safeguards individually
Strong evidence was found for a decrease in operative time and intraoperative blood loss for MIS THA , with no difference in complication rates and risk for acetabular outliers .
Strong evidence exists that there is no difference in physical functioning , measured either by question naires or by gait analysis .
Moderate evidence was found for a shorter length of hospital stay after MIS THA .
Conflicting evidence was found for a positive effect of MIS THA on pain in the early postoperative period , but that effect diminished after three months postoperatively .
Strong evidence was found for an increase in operative time for CAS THA , and limited evidence was found for a decrease in intraoperative blood loss .
Furthermore , strong evidence was found for no difference in complication rates , as well as for a significantly lower risk for acetabular outliers .
Conclusions The results indicate that MIS THA is a safe surgical procedure , without increases in operative time , blood loss , operative complication rates and component malposition rates .
However , the beneficial effect of MIS THA on functional recovery has to be proven .
The results also indicate that CAS THA , though result ing in an increase in operative time , may have a positive effect on operative blood loss and operative complication rates .
More importantly , the use of CAS results in better positioning of acetabular component of the prosthesis
Background Both minimally invasive surgery ( MIS ) and computer-assisted surgery ( CAS ) for total hip arthroplasty ( THA ) have gained popularity in recent years .
We conducted a qualitative and systematic review to assess the effectiveness of MIS , CAS and computer-assisted MIS for THA .