Deng Xinchao, Zou Man, Zhu Hongfei, Zuo Changjun, Li Kunqing, Qian Liang
Department of Orthopedics, Wuhan Eighth Hospital, Wuhan, China.
Respiratory Department, Wuhan Eighth Hospital, Wuhan, China.
Ann Palliat Med. 2021 Jul;10(7):7534-7542. doi: 10.21037/apm-21-963.
This study sought to compare the efficacy and surgery complications of the modified Broström procedure and the modified Karlsson procedure in treating patients with chronic lateral ankle instability (CLAI).
Full-text publications on the clinical efficacy of Broström's and Karlsson's procedures were retrieved from multiple databases. Review Manager 5.0 was adopted for the meta-analysis, sensitivity analysis, and bias analysis.
Nine studies comprising a total of 643 patients were identified. The meta-analysis suggested that the American Orthopedic Foot and Ankle Society (AOFAS) scores of patients in the Karlsson group were higher than those of patients in the Broström group [mean deviation (MD) =6.31, 95% confidence interval (CI): 2.31-10.30, P=0.002; P for heterogeneity <0.00001, I2=58%]. The Tegner scores of patients in the Karlsson group were higher than those of patients in the Broström group (MD =0.72, 95% CI: 0.48-0.95, P=0.24; P for heterogeneity <0.00001, I2=23%). Operation times in the Broström group were higher than those in the Karlsson group (MD =-15.50, 95% CI: -19.98--11.02, P<0.00001; P for heterogeneity <0.00001, I2=63%). Patients in the Karlsson group had higher levels of satisfaction than those in the Broström group (MD =0.63, 95% CI: 0.47-0.79, P<0.00001; P for heterogeneity =0.91, I2=0%). No significant difference was observed in surgery complications between the Karlsson and Broström groups [odds ratio (OR) =1.71, 95% CI: 0.79-3.71, P=0.18; P for heterogeneity =0.99, I2=0%].
Based on the heterogeneity analysis results, this study showed that Karlsson's procedure was more efficient and safer than Broström's treatment in the treatment of CLAI patients.
本研究旨在比较改良布罗斯特罗姆手术（modified Broström procedure）和改良卡尔松手术（modified Karlsson procedure）治疗慢性外侧踝关节不稳（CLAI）患者的疗效及手术并发症。
从多个数据库检索有关布罗斯特罗姆手术和卡尔松手术临床疗效的全文出版物。采用Review Manager 5.0进行荟萃分析、敏感性分析和偏倚分析。
共纳入9项研究，总计643例患者。荟萃分析表明，卡尔松组患者的美国矫形足踝协会（AOFAS）评分高于布罗斯特罗姆组[平均差值（MD）=6.31，95%置信区间（CI）：2.31 - 10.30，P = 0.002；异质性P<0.00001，I² = 58%]。卡尔松组患者的特格纳评分高于布罗斯特罗姆组（MD = 0.72，95% CI：0.48 - 0.95，P = 0.24；异质性P<0.00001，I² = 23%）。布罗斯特罗姆组的手术时间长于卡尔松组（MD = -15.50，95% CI：-19.98 - -11.02，P<0.00001；异质性P<0.00001，I² = 63%）。卡尔松组患者的满意度高于布罗斯特罗姆组（MD = 0.63，95% CI：0.47 - 0.79，P<0.00001；异质性P = 0.91，I² = 0%）。卡尔松组和布罗斯特罗姆组在手术并发症方面未观察到显著差异[比值比（OR） = 1.71，95% CI：0.79 - 3.71，P = 0.18；异质性P = 0.99，I² = 0%]。
基于异质性分析结果，本研究表明在治疗CLAI患者方面，卡尔松手术比布罗斯特罗姆手术更有效、更安全。
