Table 1: Features of eligible studies.

Study Compared Approaches Patients Serum Markers Results
Biomarkers
Other
(pain, function, etc)
Study Type
1. Anterior approach versus posterior approaches
Difference in biomarkers
Bergin et al. (2011) [19] Minimally invasive direct anterior (MIS-DA) vs minimally invasive posterior(MIS-PO) MIS-DA: 29MIS-PO: 28 CK, CRP, IL-6, IL-1b, TNF-a MIS-DA: Lower levels of all markers MIS-PO: Significant higher operative time and incision length PRCS
Zhao et al. (2017) [41] Anterior (DAA) vs Postero-lateral (PLA) DAA: 60
PLA:60
CRP, ESR, IL-6 DAA: Lower levels of all markers the first 4 POD DAA: Better HHS, UCLA in 3 months RCT
Poehling-Monaghan et al. (2017) [42] Anterior (DAA) vs Mini Posterior (MPO) DAA: 50
MPO: 50
CK, myoglobin, CRP, TNFa, IL-6 DAA: Lower levels of all markers with MPA Pain scores: No significant difference PRCS
No difference in biomarkers
Pilot et al. (2006) [37] Minimal invasive direct anterior (MIS-DA) vs Postero-lateral (PLA) MIS-DA: 10
PLA: 10
H-FABP, myoglobin, CK, ASAT, LDH, IL-6, IL-10 No significant differences between the groups MIS-DA: Higher blood loss (not significant), Longer operative time PRCS
Rykov et al. (2017) [43] Anterior (DAA) vs Postero-lateral (PLA) DAA: 23
PLA: 23
CK, CRP No significant differences between the groups HHS, HOOS: Similar RCT
2. Anterior approach versus lateral approaches
Difference in biomarkers
De Anta-Díaz et al. (2016) [44] Anterior (DAA) vs Lateral (LA) DAA: 49
LA: 50
IL-1, IL-6, IL-8, IL-10, IL-12, TNF, CK, ESR, CRP DAA: Lower levels of biomarkers MRI: Less soft tissue damage
HHS: Similar results
RCT
Nistor et al. (2017) [45] Anterior (DAA) vs Lateral (LA) DAA: 35
LA: 35
Myoglobin, CK, LDH DAA: Lower levels of myoglobin
CK and LDH: No significant difference
DAA: Less pain the 1st POD RCT
Mjaaland et al. (2015) [46] Minimally invasive direct anterior (MIDA) vs direct lateral (LA) MIDA: 83
LA: 80
CK, CRP LA: Lower CK levels in 4th POD MIDA: Less pain RCT
3. Anterolateral versus other approaches
Difference in biomarkers
Mouilhade et al. (2010) [47] Minimally invasive antero-lateral (Watson-Jones) approach (MIS-AL) with an AL approach with anterior hemimyotomy MIS-AL: 92 AL-HM: 49 Myoglobin, CPK MIS-AL: Lower of CPK at 1st and 2nd POD MIS-AL: Better functional outcomes at 6 weeks. Less variation of cup inclination. PRCS
Inaba et al. (2011) [48] Modified Watson-Jones (M-AL) vs modified mini-incision direct lateral approach (MIS-LA). M-AL: 57
MIS-LA: 60
CRP, CK M-AL: Lower CK levels at 1st POD Pain and functional outcome: No notable difference RCT
Muller et al. (2011) [20] Minimally invasive anterolateral (MIS-AL) vs modified direct lateral approach (M-LA). MIS-AL: 21
M-LA: 16
CK, myoglobin MIS-AL: Lower CK levels at 6 hours and 1st POD MIS-AL: Less muscle damage RCT
Matziolis et al. (2011) [49] Minimally invasive anterolateral (MIS-AL) vs minimally invasive transgluteal (MIS-TG) MIS-AL: 20
MIS-TG: 20
sTnI MIS-AL: Lower levels of sTnl the 1st POD Similar: Hospitalization, blood loss and complications RCT
No difference in biomarkers
Landgraeber et al. (2013) [50] Minimally invasive anterolateral (MIS-AL) vs conventional lateral (LA) MIS-AL: 36
LA: 40
CK, CRP No significant difference Functional outcomes and pain: No significant difference.MISAL: Longer operating time and greater blood loss RCT
4. Posterior approach versus minimally invasive posterior approach
Difference in biomarkers
Suzuki et al. (2004) [51] Conventional posterolateral (PLA) vs minimally invasive posterolateral (MIS-PLA) PLA: 39
MIS-PLA: 61
CRP, ESR, CPK MIS-PLA: Lower CRP and ESR levels at 1st week
CPK levels: No significant difference
MIS-PLA: Shorter operative time, lower blood loss, less hospital stay.
Functional outcomes: Similar
PRCS
Kwak et al. (2014) [40] Conventional posterolateral (PLA) vs minimally invasive posterolateral (MISPLA) PLA: 15
MIS-PLA: 15
CK, IL-6, IL-8, IL-10, IL-1, aldol-se MISPLA: Lower levels of CK, IL-6, IL-10, IL-1 at 1st and 3rd POD and IL-8 at 7th POD MIS-PLA: Less blood loss PRCS
No difference in biomarkers
Fink et al. (2010) [52] Conventional posterolateral (PLA) vs minimally invasive posterolateral (MIS-PLA) PLA: 50
MIS-PLA: 50
CPK, CK-MM, myoglobin, CRP No significant differences MIS-PLA: Lees pain, lower blood loss, less hospital stay PRCS
5. Lateral approach versus minimal incision lateral
Mazoochian et al. (2009) [53] Standard lateral (LA) vs minimally invasive lateral approach LA: 26
MIS-LA: 26
CK, myoglobin MIS-LA: Statistically lower myoglobin levels at 6 h postoperatively MIS-LA: Shorter operating time, less blood loss and better functional results (HHS- 6 weeks and 3 months) (WOMAC-3 months) RCT
Dienstknecht et al. (2014) [54] Conventional lateral, transgluteal approach (Bauer) (LA) vs mini-incision (MIS-LA) LA: 88
MIS-LA: 55
CK, CRP No significant difference MIS-LA: Lower VAS pain all POD / Shorter operative time RCT
6. Standard lateral and postero-lateral versus minimally invasive lateral and posterolateral
Shitama et al. (2009) [55] Conventional lateral (LA), Conventional or postero-lateral (PLA) vs minimally invasive lateral (MIS-LA) and posterolateral (MIS-PLA) LA: 8
PLA: 20
MIS-LA: 15
MIS-PLA: 19
IL-6, CRP No significant different Shorter operative time with the standard group RCT
Goosen et al. (2011) [56] Conventional lateral (LA), Conventional or postero-lateral (PLA) vs minimally invasive lateral and posterolateral LA: 20
PLA: 20
MIS-LA: 20
MIS-PLA: 20
CK, Myoglobim No significant difference Shorter operative time with the standard group Double- blind RCT
7. Three different MIS approaches
Cohen et al. (2009) [57] Modified Watson Jones (MIS-AL), vs minimally invasive posterior (MIS-I) vs minimally invasive two incision (MIS-II) MIS-AL: 10
MIS-I: 10
MIS-II: 10
CK, CPK, myoglobin No significant different Smaller duration of surgery and lower rates of blood loss with MIS-AL COS