急性跟腱修复中跟腱微创手术与开放手术的对比
Achillon versus open surgery in acute Achilles tendon repair.
作者信息
Alcelik Ilhan, Saeed Zubair M, Haughton Ben A, Shahid Rizwan, Alcelik John C, Brogden Craig, Budgen Adam
机构信息
Department of Orthopaedics, York Hospital, Wigginton Road, York YO31 8HE, United Kingdom.
Year 12, All Saints RC School, Mill Mount Lane, York YO24 1BJ, United Kingdom.
出版信息
Foot Ankle Surg. 2018 Oct;24(5):427-434. doi: 10.1016/j.fas.2017.04.016. Epub 2017 May 4.
BACKGROUND
Open Achilles tendon repairs (OATR) are associated with high complication rates. Minimally invasive surgery (MIS) techniques like the Achillon Achilles tendon repair (AATR) were developed to reduce this. We performed a systematic review and meta-analysis to compare OATR with AATR.
METHODS
We performed an extensive literature search including all studies that compared the two techniques. Outcomes assessed included overall complication rate, re-rupture rate, sural nerve injury, wound length, The American Orthopaedic Foot and Ankle Scores (AOFAS) scores and return to sports.
RESULTS
Eight studies were suitable for inclusion totalling 210 patients in the AATR group vs 233 patients in the OATR group. Total complication rates were significantly reduced in the Achillon patients with odd ratio of 0.14 (CI 95%, 0.08-0.27, P<0.00001) in favour. There were no significant differences in re-rupture rate, sural nerve injury, return to sports and AOFAS scores following repair between the two groups.
CONCLUSIONS
AATR has fewer overall complications compared with OATR. It should be considered as an alternative to open surgical repair.
背景
开放性跟腱修复术（OATR）的并发症发生率较高。为降低并发症发生率，人们开发了诸如Achillon跟腱修复术（AATR）等微创手术（MIS）技术。我们进行了一项系统评价和荟萃分析，以比较OATR与AATR。
方法
我们进行了广泛的文献检索，纳入了所有比较这两种技术的研究。评估的结果包括总体并发症发生率、再断裂率、腓肠神经损伤、伤口长度、美国矫形足踝协会（AOFAS）评分以及恢复运动情况。
结果
八项研究符合纳入标准，AATR组共有210例患者，OATR组有233例患者。Achillon组患者的总并发症发生率显著降低，优势比为0.14（95%置信区间，0.08 - 0.27，P < 0.00001）。两组修复后在再断裂率、腓肠神经损伤、恢复运动情况和AOFAS评分方面无显著差异。
结论
与OATR相比，AATR的总体并发症更少。它应被视为开放性手术修复的替代方法。
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