Herrera-Pérez M, Pais-Brito J L, de Bergua-Domingo J, Aciego de Mendoza M, Guerra-Ferraz A, Cortés-García P, Déniz-Rodríguez B
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Canarias, La Laguna, Tenerife, España; Facultad de Medicina, Universidad de La Laguna, La Laguna, Tenerife, España; Unidad de Tobillo y Pie, Hospital Universitario de Canarias, La Laguna, Tenerife, España.
Rev Esp Cir Ortop Traumatol. 2013 Nov-Dec;57(6):409-16. doi: 10.1016/j.recot.2013.07.012. Epub 2013 Oct 11.
The most common cause of osteoarthritis of the ankle is post-traumatic, and although tibiotalar arthrodesis remains the surgical gold standard, a number of techniques have been described to preserve joint mobility, such as joint distraction arthroplasty or arthrodiastasis.
To evaluate the functional outcome and changes in Visual Analogue Scale (VAS) for pain after the application of the distraction arthroplasty for post-traumatic ankle osteoarthritis.
A prospective comparative study of a group of 10 young patients with post-traumatic ankle osteoarthritis treated by synovectomy and arthrodiastasis, compared to a control group of 10 patients treated by isolated synovectomy. Results were calculated using the AOFAS scale and the VAS for pain before and after treatment.
As regards the pain measured by VAS, no difference was observed between the two groups before surgery (P=.99), but there was a difference at 3 months (P<.001), 6 months (P=.005), and 12 months (P=.006). No differences were observed in the AOFAS scale between the two groups before surgery (P=.99), or at 3 months (P<.99), but there was a difference at 6 months (P<.001).
Ankle arthrodiastasis is effective in reducing pain in post-traumatic ankle arthropathy, and is superior to isolated synovectomy.
踝关节骨关节炎最常见的病因是创伤后,尽管胫距关节融合术仍是手术的金标准,但已有多种技术被描述用于保留关节活动度,如关节牵张成形术或关节扩张术。
评估创伤后踝关节骨关节炎应用牵张成形术后的功能结局及视觉模拟评分(VAS)疼痛评分的变化。
对一组10例接受滑膜切除术和关节扩张术治疗的创伤后踝关节骨关节炎年轻患者进行前瞻性对照研究,与另一组10例仅接受滑膜切除术治疗的患者作为对照组。使用美国足踝外科协会(AOFAS)评分和治疗前后的VAS疼痛评分计算结果。
关于VAS测量的疼痛,两组术前无差异(P = 0.99),但在3个月时存在差异(P < 0.001),6个月时(P = 0.005)和12个月时(P = 0.006)。两组术前(P = 0.99)或3个月时(P < 0.99)在AOFAS评分上无差异,但在6个月时存在差异(P < 0.001)。
踝关节扩张术在减轻创伤后踝关节病疼痛方面有效,且优于单纯滑膜切除术。