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比较不同骨移植物联合关节镜辅助下关节融合术治疗创伤性距下关节炎。

Comparison of different bone graft with arthroscopy-assisted arthrodesis for the treatment of traumatic arthritis of the subtalar joint.

机构信息

Department of joint surgery, The Seventh Affiliated Hospital, Sun Yet-sun University, No. 628 Zhenyuan road, Shenzhen, 518107, Guangdong, China.

Zhujiang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.

出版信息

Int Orthop. 2020 Dec;44(12):2719-2725. doi: 10.1007/s00264-020-04834-0. Epub 2020 Sep 30.

Abstract

AIM OF THE STUDY

To compare the clinical outcomes of traumatic arthritis of the subtalar joint treated by arthroscopy-assisted arthrodesis with autologous bone graft, allogenous bone graft, artifical bone graft, and no bone graft .

METHODS

Sixty-two patients (64 ft) with traumatic arthritis of subtalar joint were randomly divided into four groups. The cases treated with arthroscopy-assisted arthrodesis were analyzed retrospectively. The mean follow-up time was about 22 months (18-28 months) in each group. Clinical outcomes were assessed by the American Orthopaedic Foot and Ankle Society (AOFAS) score, Visual Analog Scale (VAS), and radiographic examination. The post-operative complications in each group were recorded respectively.

RESULTS

All operations were successful, without incision complications. The subtalar joint obtained full osseous fusion in each group. The average time of osseous fusion was about 12 weeks. There was no significant difference in the fusion time with each group (P = 0.991). The AOFAS and VAS scores in each group were improved significantly in the pre-operative vs post-operative evaluation (all P < 0.01). The average operation time in autologous bone graft group was 74.56 ± 11.45 min which significantly different from that of other groups(P < 0.01).

CONCLUSION

Similar clinical outcomes were achieved among each type of bone graft. Therefore, which types of bone graft or not may be not the most important for arthroscopy-assisted subtalar arthrodesis.

摘要

研究目的

比较关节镜辅助融合术治疗创伤性距下关节炎时采用自体骨、同种异体骨、人工骨和不植骨的临床疗效。

方法

62 例(64 足)创伤性距下关节炎患者随机分为 4 组,回顾性分析关节镜辅助融合术治疗的病例。每组的平均随访时间约为 22 个月(18-28 个月)。采用美国矫形足踝协会(AOFAS)评分、视觉模拟评分(VAS)和影像学检查评估临床疗效。分别记录各组术后并发症。

结果

所有手术均成功,无切口并发症。各组距下关节均获得完全骨性融合。平均融合时间约为 12 周。各组融合时间无显著差异(P=0.991)。与术前相比,各组 AOFAS 和 VAS 评分均显著改善(均 P<0.01)。自体骨移植组的平均手术时间为 74.56±11.45 分钟,明显长于其他组(P<0.01)。

结论

不同类型的植骨在临床疗效上相似。因此,关节镜辅助距下融合术时是否植骨可能不是最重要的。

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