Unità Operativa C.A.S.C.O. - Piede e Caviglia, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
IRCCS Istituto Ortopedico Galeazzi, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy.
Foot Ankle Surg. 2019 Aug;25(4):418-424. doi: 10.1016/j.fas.2018.02.016. Epub 2018 Mar 6.
The purpose of this systematic review was to analyze clinical studies on total ankle replacement (TAR) whose data were extracted from national registers.
A systematic review of the literature, to identify all studies reporting outcomes after TAR, was performed. Two independent investigators performed the research using MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase and Cochrane Databases (1950 to December 2017). The search terms used were "total ankle replacement" or "total ankle arthroplasty" AND "register" or "registers" or "registry" or "registries" or "national registry" or "national register".
Analysis of the literature included 18 articles from 2007 to 2017. Of these 5 articles performed a comprehensive analysis of the national registers, 5 articles evaluated complications and reasons of failure after TAR, 6 articles made a specific outcome register analysis, one article compared TAR and ankle arthrodesis while the last one analyzed the role of TAR in patients with rheumatoid arthritis.
Scientific publications extracted from national joint registers for total ankle replacement provide useful but heterogeneous information on implants survivorship, implant models and risk factors. There is still a discrepancy between the data reported by designers in clinical studies and the data reported by the registries. The centralization of registers in specialized hospitals with dedicated surgeons, the use of patient reported outcomes (PROMs) in association with surgeon assessments and periodical publications can improve the development of registries and consequently of the literature in this regard.
本系统评价的目的是分析从国家注册中心提取数据的全踝关节置换术（TAR）的临床研究。
采用系统综述方法，检索 MEDLINE、CINAHL（护理和联合健康文献累积索引）、Embase 和 Cochrane 数据库（1950 年至 2017 年 12 月）中所有报告 TAR 后结局的研究。使用的检索词是“total ankle replacement”或“total ankle arthroplasty”和“register”或“registers”或“registry”或“registries”或“national registry”或“national register”。
文献分析纳入了 2007 年至 2017 年的 18 篇文章。其中 5 篇文章对国家注册中心进行了全面分析，5 篇文章评估了 TAR 后并发症和失败的原因，6 篇文章进行了特定的结果注册分析，1 篇文章比较了 TAR 和踝关节融合术，最后 1 篇分析了 TAR 在类风湿关节炎患者中的作用。
从全踝关节置换国家联合注册中心提取的科学出版物提供了有关植入物存活率、植入物模型和风险因素的有用但异质的信息。设计师在临床研究中报告的数据与注册中心报告的数据之间仍存在差异。在专门的外科医生所在的专科医院集中注册中心，使用患者报告的结果（PROMs）结合外科医生评估和定期出版物，可以提高注册中心的发展，并最终提高这方面的文献水平。
