Spennacchio Pietro, Cucchi Davide, Randelli Pietro S, van Dijk Niek C
IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Milan, Italy.
Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.
Knee Surg Sports Traumatol Arthrosc. 2016 Apr;24(4):1386-95. doi: 10.1007/s00167-015-3965-1. Epub 2016 Jan 7.
The 2-portal hindfoot endoscopic technique with the patient in prone position, first introduced by van Dijk et al. (Arthroscopy 16:871-876, 2000), is currently the most used by foot and ankle surgeons to address endoscopically pathologies located in the hindfoot. This article aims to review the literature to provide a comprehensive description of the level of evidence available to support the use of the 2-portal hindfoot endoscopy technique for the current generally accepted indications.
A comprehensive review was performed by use of the PubMed database to isolate literature that described therapeutic studies investigating the results of different hindfoot endoscopy treatment techniques. All articles were reviewed and assigned a classification (I-V) 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 hindfoot endoscopy. A subscale was used to further describe the evidence base for indications receiving a grade of recommendation indicating poor-quality evidence.
On the basis on the available evidence, posterior ankle impingement syndrome, subtalar arthritis and retrocalcaneal bursitis have the strongest recommendation in favour of treatment (grade Cf).
Although a low level of evidence of the included studies, the review showed that adequate literature to support the use of the 2-portal endoscopic techniques for most currently accepted indications exists. Future "higher quality" evidence could strengthen current recommendations and further help surgeons in evidence-based practice.
Level V, Review of Level III, IV and V studies.
由范·迪克等人（《关节镜检查》16:871 - 876，2000年）首次提出的患者俯卧位双入路后足内镜技术，目前是足踝外科医生在内镜下处理后足病变时最常用的技术。本文旨在回顾文献，全面描述现有证据水平，以支持双入路后足内镜技术用于当前普遍认可的适应证。
通过使用PubMed数据库进行全面检索，以筛选出描述不同后足内镜治疗技术结果的治疗性研究文献。对所有文章进行评审，并赋予证据水平分类（I - V）。对所评审的文献进行分析，为后足内镜当前普遍认可的每个适应证赋予推荐等级。使用一个子量表进一步描述获得低质量证据推荐等级的适应证的证据基础。
基于现有证据，踝关节后方撞击综合征、距下关节炎和跟腱后滑囊炎最强烈推荐采用该技术治疗（Cf级）。
尽管纳入研究的证据水平较低，但该综述表明，有足够的文献支持双入路内镜技术用于当前大多数被认可的适应证。未来“更高质量”的证据可能会强化当前的推荐，并进一步帮助外科医生进行循证实践。
V级，III、IV和V级研究的综述。
