Comparison of Total Ankle Replacement and Ankle Arthrodesis for Ankle Arthropathy in Patients With Bleeding Disorders: A Systematic Review and Meta-Analysis.
Rodney Y Arthur, Alexander K Mihas, James Harris, Logan A Reed, Rebecca Billings, David A Patch, Clay A Spitler, Michael D Johnson
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引用次数: 0
Abstract
Background: There is limited literature comparing the publications on ankle arthrodesis (AA) and total ankle arthroplasty (TAA) in the setting of hemophilic arthropathy. Our objective is to systematically review the existing literature and to assess ankle arthroplasty as an alternative to ankle arthrodesis in this patient population.
Methods: This systematic review was conducted and presented according to the PRISMA statement standards. A search was conducted on March 7-10, 2023, using MEDLINE (via PubMed), Embase, Scopus, ClinicalTrials.gov, CINAHL Plus with Full Text, and the Cochrane Central Register of Controlled Studies. This search was restricted to full-text human studies published in English, and articles were screened by 2 masked reviewers. Systematic reviews, case reports with less than 3 subjects, letters to the editor, and conference abstracts were excluded. Two independent reviewers rated study quality using the MINORS tool.
Results: Twenty-one of 1226 studies were included in this review. Thirteen articles reviewed the outcomes associated with AA in hemophilic arthropathy whereas 10 reviewed the outcomes associated with TAA. Two of our studies were comparative and reviewed the outcomes of both AA and TAA. Additionally, 3 included studies were prospective. Studies showed that the degree of improvement in American Orthopaedic Foot & Ankle Society hindfoot-ankle score, visual analog scale pain scores, and the mental and physical component summary scores of the 36-Item Short Form Health Survey were similar for both surgeries. Complication rates were also similar between the 2 surgeries. Additionally, studies showed a significant improvement in ROM after TAA.
Conclusion: Although the level of evidence in this review varies and results should be interpreted with caution, the current literature suggests similar clinical outcomes and complication rates between TAA and AA in this patient population.
背景：关于血友病关节病的踝关节置换术（AA）和全踝关节置换术（TAA）的文献比较有限。我们的目的是系统回顾现有文献，并评估踝关节成形术作为踝关节置换术的替代方案在这类患者中的应用情况：本系统性综述根据 PRISMA 声明标准进行并提交。2023年3月7-10日，我们使用MEDLINE（通过PubMed）、Embase、Scopus、ClinicalTrials.gov、CINAHL Plus with Full Text和Cochrane对照研究中央登记册进行了检索。该检索仅限于以英语发表的人类研究报告全文，文章由两名蒙面审稿人进行筛选。系统综述、受试者少于 3 人的病例报告、致编辑的信和会议摘要均被排除在外。两位独立审稿人使用 MINORS 工具对研究质量进行评分：本综述共纳入了 1226 项研究中的 21 项。13篇文章回顾了血友病关节病 AA 的相关结果，10篇文章回顾了 TAA 的相关结果。我们的两项研究是比较性的，同时回顾了 AA 和 TAA 的结果。此外，我们还纳入了 3 项前瞻性研究。研究显示，两种手术在美国骨科足踝协会后足-踝关节评分、视觉模拟量表疼痛评分、36项简表健康调查的精神和身体部分汇总评分方面的改善程度相似。两种手术的并发症发生率也相似。此外，研究还显示TAA术后ROM有明显改善：尽管本综述的证据水平参差不齐，对结果的解释也应谨慎，但目前的文献表明，在这一患者群体中，TAA 和 AA 的临床结果和并发症发生率相似。
期刊介绍：
Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers.
The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008.
The journal focuses on the following areas of interest:
• Surgery
• Wound care
• Bone healing
• Pain management
• In-office orthotic systems
• Diabetes
• Sports medicine
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