Orthopaedic Department, University Hospital of Canary Islands, Carretera La Cuesta s/n, 38320, San Cristóbal de La Laguna, Tenerife, Spain.
Orthopaedic Department, College of Medicine, Taibah University, Medina, Kingdom of Saudi Arabia.
Knee Surg Sports Traumatol Arthrosc. 2019 Sep;27(9):2802-2812. doi: 10.1007/s00167-018-5156-3. Epub 2018 Sep 27.
To evaluate and compare complication rates and postoperative outcomes in patients with ankle debridement alone vs. debridement and hinged ankle distraction arthroplasty.
A total of 50 patients with posttraumatic ankle osteoarthritis (OA) with a mean age of 40.0 ± 8.5 years were included into this prospective randomized study: 25 patients in ankle debridement alone group and 25 patients in debridement and hinged ankle distraction group. The mean follow-up was 46 ± 12 months (range 36-78 months). The clinical and radiographic outcomes were evaluated at the 6-month and 3-year follow-up using the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, SF-36 quality of life score, and van Dijk OA classification. A Kaplan-Meier survival analysis was performed to calculate the 3-year and 5-year survival rates.
Both patient groups experienced significant pain relief, functional improvement, and improvement in quality of life postoperatively. In total, 26 major secondary procedures were performed. The overall survival rates in the debridement and ankle distraction group were 19 of 25 (74%) and 15 of 25 (59%) at 3 years and 5 years, respectively. The overall survival rates in the ankle debridement alone group were 12 of 25 (49%) and 9 of 25 (34%) at 3 years and 5 years, respectively.
The study demonstrated comparable postoperative functional outcome and quality of life. However, rate of postoperative revision surgery was substantially higher in ankle debridement alone group.
Randomized controlled study, Level I.
评估和比较单纯踝关节清创术与清创加铰链式踝关节牵张关节成形术治疗创伤后踝关节骨关节炎（OA）的并发症发生率和术后结果。
本前瞻性随机研究纳入了 50 例平均年龄为 40.0±8.5 岁的创伤后踝关节 OA 患者：单纯踝关节清创术组 25 例，清创加铰链式踝关节牵张关节成形术组 25 例。平均随访 46±12 个月（36-78 个月）。术后 6 个月和 3 年时采用视觉模拟评分（VAS）、美国矫形足踝协会（AOFAS）后足评分、SF-36 生活质量评分和 van Dijk OA 分类评估临床和影像学结果。采用 Kaplan-Meier 生存分析计算 3 年和 5 年的生存率。
两组患者术后均有明显的疼痛缓解、功能改善和生活质量提高。共进行了 26 例次要手术。清创加踝关节牵张组的 3 年和 5 年总体生存率分别为 25 例中的 19 例（74%）和 15 例（59%），单纯踝关节清创术组分别为 25 例中的 12 例（49%）和 9 例（34%）。
该研究表明两种手术方法的术后功能结果和生活质量相当，但单纯踝关节清创术组术后翻修手术的发生率明显更高。
随机对照研究，Ⅰ级。
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