使用人工合成软骨植入物半关节置换术或关节融合术治疗第一跖趾关节关节炎：手术时间与恢复时间的比较
Treatment of first metatarsophalangeal joint arthritis using hemiarthroplasty with a synthetic cartilage implant or arthrodesis: A comparison of operative and recovery time.
作者信息
Glazebrook Mark, Younger Alastair S E, Daniels Timothy R, Singh Dishan, Blundell Chris, de Vries Gwyneth, Le Ian L D, Nielsen Dominic, Pedersen M Elizabeth, Sakellariou Anthony, Solan Matthew, Wansbrough Guy, Baumhauer Judith F
机构信息
Dalhousie University and Queen Elizabeth II Health Sciences Center, Halifax Infirmary (Room 4867), 1796 Summer Street, Halifax, Nova Scotia B3H 3A7, Canada.
Department of Orthopaedics, University of British Columbia, 560-1144 Burrard Street, Vancouver, British Columbia V6Z 2A5, Canada.
出版信息
Foot Ankle Surg. 2018 Oct;24(5):440-447. doi: 10.1016/j.fas.2017.05.002. Epub 2017 May 29.
BACKGROUND
First metatarsophalangeal joint (MTPJ1) hemiarthroplasty using a novel synthetic cartilage implant was as effective and safe as MTPJ1 arthrodesis in a randomized clinical trial. We retrospectively evaluated operative time and recovery period for implant hemiarthroplasty (n=152) and MTPJ1 arthrodesis (n=50).
METHODS
Perioperative data were assessed for operative and anaesthesia times. Recovery and return to function were prospectively assessed with the Foot and Ankle Ability Measure (FAAM) Sports and Activities of Daily Living (ADL) subscales and SF-36 Physical Functioning (PF) subscore.
RESULTS
Mean operative time for hemiarthroplasty was 35±12.3min and 58±21.5min for arthrodesis (p<0.001). Anaesthesia duration was 28min shorter with hemiarthroplasty (p<0.001). At weeks 2 and 6 postoperative, hemiarthroplasty patients demonstrated clinically and statistically significantly higher FAAM Sport, FAAM ADL, and SF-36 PF subscores versus arthrodesis patients.
CONCLUSION
MTPJ1 hemiarthroplasty with a synthetic cartilage implant took less operative time and resulted in faster recovery than arthrodesis.
LEVEL OF EVIDENCE
III, Retrospective case control study.
背景
在一项随机临床试验中，使用新型合成软骨植入物进行第一跖趾关节（MTPJ1）半关节成形术与MTPJ1关节融合术一样有效且安全。我们回顾性评估了植入物半关节成形术（n = 152）和MTPJ1关节融合术（n = 50）的手术时间和恢复期。
方法
评估围手术期数据的手术时间和麻醉时间。使用足踝能力测量（FAAM）运动和日常生活活动（ADL）子量表以及SF-36身体功能（PF）子评分对恢复情况和功能恢复进行前瞻性评估。
结果
半关节成形术的平均手术时间为35±12.3分钟，关节融合术为58±21.5分钟（p<0.001）。半关节成形术的麻醉持续时间短28分钟（p<0.001）。术后第2周和第6周，半关节成形术患者在临床上和统计学上的FAAM运动、FAAM ADL和SF-36 PF子评分均显著高于关节融合术患者。
结论
使用合成软骨植入物进行MTPJ1半关节成形术比关节融合术手术时间更短，恢复更快。
证据级别
III，回顾性病例对照研究。
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