Kluesner Andrew J, Wukich Dane K
Department of Surgery, University of Pittsburgh Medical Center, South Side Hospital, Pittsburgh, PA, USA.
Clin Podiatr Med Surg. 2009 Apr;26(2):227-44. doi: 10.1016/j.cpm.2008.12.006.
Ankle joint distraction, or arthrodiastasis, has emerged as a viable treatment alternative for recalcitrant ankle arthritis. This joint salvage procedure avoids the potential complications associated with joint arthrodesis or joint arthroplasty in the young patient population typically affected by posttraumatic ankle arthritis. The treatment is predicated on the knowledge that osteoarthritic ankle cartilage is capable of repair. The reparative capacity of the ankle chondrocyte is enhanced through the mechanical offloading of the joint and maintenance of intra-articular fluid pressure changes. Scientific data demonstrate positive biochemical and biomechanical intra-articular changes associated with joint distraction, facilitating an environment for cartilage repair. Clinical studies, although limited, have resulted in significant patient benefit in the short-term and long-term treatment of arthritis. Further studies are needed to evaluate this technique and its ideal indication. Current literature does support its use in the treatment of ankle arthritis, however.
踝关节牵张术，即关节分离术，已成为治疗顽固性踝关节关节炎的一种可行替代方法。这种关节挽救手术可避免在通常受创伤后踝关节关节炎影响的年轻患者群体中与关节融合术或关节置换术相关的潜在并发症。该治疗基于骨关节炎性踝关节软骨能够修复这一认知。通过关节的机械卸载和维持关节内流体压力变化，可增强踝关节软骨细胞的修复能力。科学数据表明，与关节牵张相关的关节内生化和生物力学变化呈阳性，为软骨修复创造了有利环境。临床研究虽然有限，但在关节炎的短期和长期治疗中已给患者带来显著益处。需要进一步研究来评估该技术及其理想适应证。不过，当前文献确实支持其用于治疗踝关节关节炎。
