Zhao Hong-mou, Yang Yun-feng, Yu Guang-rong
Department of Orthopaedic Trauma, Tongji University, Shanghai, China.
Zhonghua Wai Ke Za Zhi. 2011 Aug 1;49(8):737-40.
To provide a cumulative data about the complications of second or third generation ankle prostheses in the literature, and to provide a summary high-grade complications associated with implant failure.
A comprehensive search for all relevant articles published in English from January 1995 to December 2010 was conducted. Two reviewers evaluated each study to determine whether it was eligible for inclusion and collected the data of interest. Meta-analytic pooling of results across studies was performed for the complications and failure rate.
Thirty-five primary studies with 4395 implants were identified. The three highest complications of total ankle arthroplasty were aseptic loosening (12.51%), intra-operative bone fracture (11.97%) and bony impingement (11.27%). The three high-grade complications associated with implant failure were aseptic loosening (45.00%), infection (33.00%) and malalignment (29.00%). The pooled mean failure rate was 10.98% (95%CI: 8.80% - 13.16%), and the pooled mean failure rate of STAR implant was 14.20% (95%CI: 10.64% - 17.76%).
It is found that aseptic loosening, infection and malalignment are high-grade complications associated with implant failure in total ankle arthroplasty. The orthopaedic surgeons should be more careful in the operation, and the patients should coordinate with the post-operative rehabilitation plan.
提供文献中关于第二代或第三代踝关节假体并发症的累积数据，并总结与植入物失败相关的高级别并发症。
对1995年1月至2010年12月以英文发表的所有相关文章进行全面检索。两名审阅者评估每项研究以确定其是否符合纳入标准，并收集感兴趣的数据。对各项研究的并发症和失败率进行荟萃分析合并。
确定了35项涉及4395例植入物的主要研究。全踝关节置换术的三大最高并发症为无菌性松动（12.51%）、术中骨折（11.97%）和骨撞击（11.27%）。与植入物失败相关的三大高级别并发症为无菌性松动（45.00%）、感染（33.00%）和排列不齐（29.00%）。汇总平均失败率为10.98%（95%置信区间：8.80% - 13.16%），STAR植入物的汇总平均失败率为14.20%（95%置信区间：10.64% - 17.76%）。
发现无菌性松动、感染和排列不齐是全踝关节置换术中与植入物失败相关的高级别并发症。骨科医生在手术中应更加小心，患者应配合术后康复计划。
