Distal tibial osteotomy for varus ankle arthritis: A meta-analysis and systematic review

Q4 Medicine
Randeep S. Aujla, Ganapathy Perianayagam, Bobby M. Siddiqui, Pip Divall, Maneesh Bhatia
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引用次数: 0

Abstract

Joint preserving surgical options are essential in modern orthopaedic care. The aim of this study was to review current literature about distal tibial osteotomies for varus osteoarthritis of the ankle joint. A clinical librarian searched electronic from inception to August 2019 using standard terms. Studies that assessed distal tibial osteotomy outcomes (clinical, radiological and complications) in the treatment of varus ankle osteoarthritis with a minimum of one-year follow-up. The search identified 968 studies. Duplicates (225) were removed. On applying inclusion/exclusion criteria to title and abstract review 686 papers were excluded. 57 full-texts were reviewed and a further 45 were excluded. Twelve papers underwent quality assessment and finally only nine included. The nine papers underwent full data extraction and inclusion within the study. Pain scores (VAS) improved in all studies examined. Mean pooled pre-operative VAS was 7.0 and post-operative VAS was 2.5. These results were for 166 ankles. Mean pooled Pre- and post-operative AOFAS scores available for nine studies showed an improvement from 57.7 to 83.6 for 242 ankles. Satisfaction rates were 89.1% from four studies, including 92 ankles. Out of the total number of osteotomies (242) there were four (1.7%) patients who underwent total ankle arthroplasty and five (2.1%) who had arthrodesis at mean follow-up of 45 months (range; 21–99). Distal tibial osteotomy can provide significant pain relief and improvement in functional scores. Satisfaction is high with a low level of complications. It is a viable option for joint preservation in carefully selected patients.

胫骨远端截骨治疗踝关节内翻:荟萃分析和系统回顾
关节保留手术选择是必不可少的现代骨科护理。本研究的目的是回顾目前关于胫骨远端截骨术治疗踝关节内翻性骨关节炎的文献。临床图书管理员使用标准术语从成立到2019年8月进行电子检索。评估胫骨远端截骨治疗踝关节内翻性骨关节炎的疗效(临床、影像学和并发症)的研究,随访时间至少为一年。这项研究确定了968项研究。重复(225)被删除。在标题和摘要评审中应用纳入/排除标准时,686篇论文被排除在外。审查了57份全文,另有45份被排除在外。12篇论文进行了质量评估,最终只有9篇论文被收录。对这9篇论文进行了完整的数据提取和纳入研究。所有研究的疼痛评分(VAS)均有所改善。平均合并术前VAS为7.0,术后VAS为2.5。这些结果是针对166个脚踝的。9项研究的平均术前和术后综合AOFAS评分显示242例踝关节从57.7改善到83.6。包括92个踝关节在内的4项研究满意率为89.1%。在242例截骨手术中,4例(1.7%)患者接受了全踝关节置换术,5例(2.1%)患者接受了关节融合术,平均随访时间为45个月(范围;21 - 99)。胫骨远端截骨术可以显著缓解疼痛并改善功能评分。满意度高,并发症低。在精心挑选的患者中,这是一种可行的关节保护选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Arthroscopy and Joint Surgery
Journal of Arthroscopy and Joint Surgery Medicine-Orthopedics and Sports Medicine
CiteScore
0.60
自引率
0.00%
发文量
1
期刊介绍: Journal of Arthroscopy and Joint Surgery (JAJS) is committed to bring forth scientific manuscripts in the form of original research articles, current concept reviews, meta-analyses, case reports and letters to the editor. The focus of the Journal is to present wide-ranging, multi-disciplinary perspectives on the problems of the joints that are amenable with Arthroscopy and Arthroplasty. Though Arthroscopy and Arthroplasty entail surgical procedures, the Journal shall not restrict itself to these purely surgical procedures and will also encompass pharmacological, rehabilitative and physical measures that can prevent or postpone the execution of a surgical procedure. The Journal will also publish scientific research related to tissues other than joints that would ultimately have an effect on the joint function.
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