Akshay R Reddy, Hailey Hampton, Wojciech K Dzieza, R James Toussaint
{"title":"Nitinol Compression Staples in Foot Orthopaedic Surgery: A Systematic Review.","authors":"Akshay R Reddy, Hailey Hampton, Wojciech K Dzieza, R James Toussaint","doi":"10.1177/24730114241300158","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Nitinol compression staples have been increasingly used in foot and ankle orthopaedic surgery because of simple implantation, reproducibility, and favorable biomechanical features. Compared with traditional implants (i.e., plates and screws), nitinol staple use in foot and ankle orthopaedics has not been extensively described. This systematic review aims to describe the current clinical outcomes of nitinol staple use in forefoot and midfoot surgery.</p><p><strong>Methods: </strong>A search was conducted using PubMed, Web of Science, and Embase. All studies that included clinical outcomes of nitinol in foot surgery were evaluated for their demographics, outcome scores, or complication rates. Biomechanical studies and studies investigating nitinol nails in the hindfoot were excluded. Two reviewers screened titles, abstracts, and full texts.</p><p><strong>Results: </strong>Of the 198 total articles from the search, 9 articles met the inclusion criteria. Of the 9 articles, 4 articles investigated outcomes of nitinol in the forefoot, 3 articles in the midfoot, 1 article in the forefoot and midfoot, and 1 article in the midfoot and hindfoot. This systematic review included articles that were retrospective in nature and thus subject to selection bias. The mean follow-up ranged from 6 to 35.9 months. The included studies demonstrated significantly improved postoperative visual analog scale pain score (<i>P</i> < .001), Ankle Osteoarthritis Scale scores (<i>P</i> < .001), and Foot and Ankle Ability Measure activities of daily living scores (<i>P</i> < .001). Of the 6 studies that report union for patients receiving purely nitinol staple constructs or nitinol staples in combination with another construct, the overall fusion rate was 94.6% and the overall complication rate was 11.25%.</p><p><strong>Conclusion: </strong>This systematic review demonstrates that nitinol staples in foot surgery, whether alone or in combination with another construct, can achieve an acceptable fusion rate. However, currently we found highly limited clinical study data directly comparing nitinol staples to traditional implants. The current literature is heterogenous in its discussion of nitinol staple configurations and designs.</p><p><strong>Level of evidence: </strong>Level IV, Systematic Review.</p>","PeriodicalId":12429,"journal":{"name":"Foot & Ankle Orthopaedics","volume":"9 4","pages":"24730114241300158"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607750/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot & Ankle Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/24730114241300158","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Nitinol compression staples have been increasingly used in foot and ankle orthopaedic surgery because of simple implantation, reproducibility, and favorable biomechanical features. Compared with traditional implants (i.e., plates and screws), nitinol staple use in foot and ankle orthopaedics has not been extensively described. This systematic review aims to describe the current clinical outcomes of nitinol staple use in forefoot and midfoot surgery.
Methods: A search was conducted using PubMed, Web of Science, and Embase. All studies that included clinical outcomes of nitinol in foot surgery were evaluated for their demographics, outcome scores, or complication rates. Biomechanical studies and studies investigating nitinol nails in the hindfoot were excluded. Two reviewers screened titles, abstracts, and full texts.
Results: Of the 198 total articles from the search, 9 articles met the inclusion criteria. Of the 9 articles, 4 articles investigated outcomes of nitinol in the forefoot, 3 articles in the midfoot, 1 article in the forefoot and midfoot, and 1 article in the midfoot and hindfoot. This systematic review included articles that were retrospective in nature and thus subject to selection bias. The mean follow-up ranged from 6 to 35.9 months. The included studies demonstrated significantly improved postoperative visual analog scale pain score (P < .001), Ankle Osteoarthritis Scale scores (P < .001), and Foot and Ankle Ability Measure activities of daily living scores (P < .001). Of the 6 studies that report union for patients receiving purely nitinol staple constructs or nitinol staples in combination with another construct, the overall fusion rate was 94.6% and the overall complication rate was 11.25%.
Conclusion: This systematic review demonstrates that nitinol staples in foot surgery, whether alone or in combination with another construct, can achieve an acceptable fusion rate. However, currently we found highly limited clinical study data directly comparing nitinol staples to traditional implants. The current literature is heterogenous in its discussion of nitinol staple configurations and designs.
背景：镍钛诺压钉由于其植入简单、可重复性和良好的生物力学特性，已越来越多地应用于足部和踝关节骨科手术。与传统的植入物（即钢板和螺钉）相比，镍钛诺钉钉在足部和踝关节矫形术中的应用尚未得到广泛的报道。本系统综述旨在描述镍钛诺钉在前足和中足手术中使用的临床结果。方法：使用PubMed、Web of Science和Embase进行检索。所有包括镍钛诺在足部手术中的临床结果的研究都评估了其人口统计学、结果评分或并发症发生率。生物力学研究和后足镍钛诺钉的研究被排除在外。两位审稿人筛选了题目、摘要和全文。结果：检索到的198篇文章中，有9篇符合纳入标准。在这9篇文章中，4篇研究了镍钛诺在前足的效果，3篇研究了中足，1篇研究了中足，1篇研究了中足和后足。本系统综述纳入了具有回顾性的文章，因此存在选择偏倚。平均随访6 ~ 35.9个月。纳入的研究显示，术后视觉模拟量表疼痛评分显著提高（P P P P）。结论：本系统综述表明，无论是单独使用镍钛诺钉还是与其他结构物联合使用，在足部手术中均可达到可接受的融合率。然而，目前我们发现非常有限的临床研究数据直接比较镍钛诺钉与传统种植体。目前的文献对镍钛诺短钉结构和设计的讨论是不一致的。证据等级：四级，系统评价。
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