Array.
Department of Orthopaedic Surgery, University Hospital of Udine, Udine, Italy.
Acta Biomed. 2020 Dec 30;91(14-S):e2020021. doi: 10.23750/abm.v91i14-S.10989.
Ankle arthrodesis has been considered the surgical Gold Standard for advanced ankle arthritis; prosthetic replacement of the tibio-talar joint played a secondary role.The introduction of last generation ankle prostheses lead to better outcome and a lower rate of complication. PSI represents the most recent innovations introduced on the market of ankle arthroplasty:PSI is proposed as a surgical technique capable of making ankle arthroplasty more accurate and more reproducible compared to standard referencing guides Aim of the study is to report early clinical and radiographic outcomes obtained from a single surgeon experience by implanting the same ankle prosthesis using a standard (STD) or a PSI instrumentation Unlike no difference in the average increment of normalized sub score related to function in each group (PSI vs STD), the analysis of normalized pain sub score pointed out a greater average improvement in the PSI group(+75%)compared to the STD group(+62%);this result has been adovacated to the absence of post operative gutter impingement syndrome in the PSI group compared to the STD referencing group. The analysis of radiographic angles revealed a more accurate and reproducible positioning of the components in the PSI group; ankle arthroplasty performed with PSI reported a reduction of both surgical times and the need of intraop.fluoroscopy. PSI ankle arthroplasty achived more accurate and reproducible clinical and radiographic results compared to STD instrumentation;long-term follow-up are needed to demonstrate whether a better positioning of the implant is associated with an increased survival of the prosthesis and therefore justifies the additional costs of PSI.
踝关节融合术一直被认为是晚期踝关节关节炎的金标准手术；而距下关节假体置换则处于次要地位。上一代踝关节假体的出现带来了更好的结果和更低的并发症发生率。PSI 代表了踝关节置换领域最新的创新：PSI 被提出作为一种手术技术，与标准参考指南相比，能使踝关节置换更精确、更可重复。本研究旨在报告一位外科医生采用相同的踝关节假体，分别使用标准（STD）或 PSI 器械进行手术的早期临床和放射学结果。与每组的功能相关的标准化子评分的平均增量无差异（PSI 与 STD）不同，标准化疼痛子评分的分析表明 PSI 组的平均改善更大（+75%），而 STD 组（+62%）；这一结果归因于 PSI 组与 STD 参考组相比，术后沟撞击综合征的发生率较低。对放射学角度的分析显示，PSI 组的组件定位更准确和可重复；与 STD 器械相比，使用 PSI 进行的踝关节置换术减少了手术时间和术中透视的需要。与 STD 器械相比，PSI 踝关节置换术在临床和放射学结果上取得了更准确和可重复的效果；需要长期随访来证明植入物的更好定位是否与假体的存活率增加相关，从而证明 PSI 的额外成本是合理的。
