摘要目的:本研究目的是比较直接前入路(DAA)与后外侧入路(PA)全髋关节置换术后的步态运动学的差异。方法:2024年9月检索PubMed、Web of Science、中国知网和万方数据库，收集2004年8月至2024年8月间关于直接前入路和后外侧入路全髋置换术后步态运动学的随机对照试验。按纳入和排除标准纳入文献，并根据手术入路方式不同分为DAA组和PA组。采用Cochrane协作工具评估随机对照试验的偏倚风险，Meta分析使用软件Review Manager(Rev Man 5.4)进行。采用I 2统计量和卡方检验评估异质性，根据异质性结果选择固定效应模型或随机效应模型进行合并分析。 结果:10篇文献最终纳入本次研究。5项研究比较了DAA组和PA组术后3个月时步幅差异，且Meta分析显示DAA组的步幅大于PA组( OR：7.76，95% CI：6.66~8.86， P<0.05， Z＝13.86)。两组患者术后3个月的步速差异无统计学意义( OR：0.10，95% CI：－0.05~0.24， P>0.05， Z＝1.33)，步频也差异无统计学意义( OR：4.81，95% CI：－2.65~12.27， P>0.05， Z＝1.26)。 结论:DAA组在术后3个月的步幅优于PA组，而步速和步频差异无统计学意义。

abstractsObjective:The objective of this study was to compare the differences in gait kinematics between direct anterior approach (DAA) and posterolateral approach (PA) after total hip arthroplasty.Methods:In September 2024, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched to collect randomized controlled trials on gait kinematics after total hip arthroplasty via direct anterior approach and posterolateral approach from August 2004 to August 2024. The literature was included and excluded according to the inclusion and exclusion criteria, and was divided into the DAA group and the PA group based on the different surgical approaches. The risk of bias in randomized controlled trials was assessed using the Cochrane Collaboration tool. We used the I 2 statistic and chi-square test to assess heterogeneity. Based on the results of heterogeneity, we chose either the fixed-effect model or the random-effect model for combined analysis. The meta-analysis was performed using the software Review Manager (Rev Man 5.4). Results:10 literatures were finally included in this study. Five studies compared the difference in stride length between the two groups at 3 months after surgery, and the DAA group was significantly larger than the PA group [odds tatio ( OR): 7.76, 95% confidence interval ( CI): 6.66-8.86, Z=13.86, P<0.05]. There was no statistically significant difference in walking speed between the two groups of patients at 3 months after the operation ( OR: 0.10, 95% CI: -0.05-0.24, Z=1.33, P>0.05), nor was there a statistically significant difference in step frequency ( OR: 4.81, 95% CI: -2.65-12.27, Z=1.26, P>0.05). Conclusion:The stride length of the DAA group was significantly better than that of the PA group at 3 months after surgery, while there was no significant difference in gait speed and cadence.