Hassouna Hazem, Kumar Skand, Bendall Stephen
Trauma and Orthopaedics Department, Brighton and Sussex University Hospitals, East Sussex, UK.
Acta Orthop Belg. 2007 Dec;73(6):737-40.
Little information exists regarding the long term prognosis following ankle arthroscopy, particularly in avoiding further major surgery. The purpose of this study is to evaluate the prognosis of arthroscopic ankle treatment. We also investigated the relationship between the arthroscopic treatment and time for a further major ankle surgery. In this consecutive case series study using a prospectively collected database, 80 consecutive patients (80 ankles) having ankle arthroscopy with the finding of osteoarthritis or impingement were identified and their outcome at five years was ascertained. Fifty five (69%) patients had soft tissue impingement, and 25 (31%) patients had osteoarthritic degenerative changes. Seven (9%) patients had further major surgery and 6 (8%) had repeat arthroscopy. The surgery was required for 7 arthritic ankles among which, however, survival analysis showed no significant difference between those under 50 and those over 50 years. Twenty-eight percent of osteoarthritic patients progressed to major ankle surgery, within 5 years of arthroscopic treatment. None of the patients with impingement symptoms required further major surgery. In conclusion, arthroscopically treated impingement ankles were found to have an excellent prognosis, while osteoarthritic ankles had a less favoured prognosis, with a high proportion requiring further major surgery. Age did not appear to affect the prognosis in the osteoarthritic group.
关于踝关节镜检查后的长期预后,尤其是在避免进一步进行大手术方面,现有信息较少。本研究的目的是评估踝关节镜治疗的预后。我们还研究了关节镜治疗与再次进行踝关节大手术时间之间的关系。在这项使用前瞻性收集数据库的连续病例系列研究中,确定了80例连续接受踝关节镜检查且发现骨关节炎或撞击症的患者(80个踝关节),并确定了他们五年后的结局。55例(69%)患者有软组织撞击症,25例(31%)患者有骨关节炎退行性改变。7例(9%)患者接受了进一步的大手术,6例(8%)患者接受了再次关节镜检查。7个患有关节炎的踝关节需要进行手术,然而,生存分析显示50岁以下和50岁以上患者之间没有显著差异。在关节镜治疗后的5年内,28%的骨关节炎患者进展为踝关节大手术。有撞击症状的患者均无需进一步进行大手术。总之,经关节镜治疗的有撞击症的踝关节预后良好,而患骨关节炎的踝关节预后较差,有很大比例需要进一步进行大手术。年龄似乎不影响骨关节炎组的预后。