Department of Orthopaedic Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Arthroscopy. 2009 Dec;25(12):1478-90. doi: 10.1016/j.arthro.2009.05.001.
The purpose of this study was to review the literature to provide a comprehensive description of the Level of Evidence available to support the surgical technique of ankle arthroscopy for the current generally accepted indications and assign a grade of recommendation for each of them.
A comprehensive review of the literature was performed (in August 2008) by use of the PubMed database. The abstracts from these searches were reviewed to isolate literature that described therapeutic studies investigating the results of different ankle arthroscopic treatment techniques. All articles were reviewed and assigned a classification (I-IV) of Level of Evidence. An analysis of the literature reviewed was used to assign a grade of recommendation for each current generally accepted indication for ankle arthroscopy.
There exists fair evidence-based literature (grade B) to support a recommendation for the use of ankle arthroscopy for the treatment of ankle impingement and osteochondral lesions and for ankle arthrodesis. Ankle arthroscopy for ankle instability, septic arthritis, arthrofibrosis, and removal of loose bodies is supported with only poor-quality evidence (grade C). Treatment of ankle arthritis, excluding isolated bony impingement, is not effective and therefore this indication is not recommended (grade C against). Finally, there is insufficient evidence-based literature to support or refute the benefit of arthroscopy for the management of synovitis and fractures (grade I).
There exists adequate evidence-based literature to support the surgical technique of ankle arthroscopy for most current generally accepted indications; however, further studies in this area are needed.
Level IV, systematic review.
本研究旨在回顾文献，全面描述支持踝关节镜手术的现有证据水平，并为其目前公认的适应证中的每一个适应证分配推荐等级。
在 2008 年 8 月，我们使用 PubMed 数据库进行了全面的文献回顾。对这些检索的摘要进行了回顾，以筛选出描述不同踝关节镜治疗技术治疗结果的治疗研究文献。对所有文章进行了回顾，并对其进行了分类（I-IV）证据水平。对所回顾的文献进行了分析，以确定目前踝关节镜公认适应证的推荐等级。
有支持踝关节镜治疗踝关节撞击和骨软骨病变以及踝关节融合术的良好循证文献（B 级）。踝关节镜治疗踝关节不稳定、化脓性关节炎、关节纤维性强直和游离体切除仅得到低质量证据的支持（C 级）。治疗关节炎，除了孤立的骨撞击外，效果不佳，因此不推荐该适应证（C 级）。最后，没有足够的循证文献支持或反驳关节镜治疗滑膜炎和骨折的益处（I 级）。
有足够的循证文献支持目前大多数公认的适应证的踝关节镜手术技术；然而，该领域还需要进一步的研究。
IV 级，系统评价。
