Senior Resident, Department of Orthopedic Surgery, Foot and Ankle Division, Hvidovre University Hospital, Copenhagen, Denmark.
Foot and Ankle Surgeon, Chief Physician, Department of Orthopedic Surgery, Foot and Ankle Division, Hvidovre University Hospital, Copenhagen, Denmark.
J Foot Ankle Surg. 2022 Jul-Aug;61(4):888-895. doi: 10.1053/j.jfas.2021.12.017. Epub 2021 Dec 18.
Osteochondral lesions of talus are a common injury where surgery is indicated in case of failed non-operative treatment or displaced lesions. Many studies have been conducted on the effectiveness of the AMIC procedure. The goal of our study is to create an overview of the current literature. A systematic search adhering to the PRISMA guidelines was conducted in PubMed (MEDLINE) and EMBASE on May 27, 2020. All included studies were evaluated according to the modified Coleman Methodology Score and information on study type, patient numbers, age, follow-up period, grade, location and size of the lesion, study in- and exclusion criteria, associated surgery, surgical technique, scaffold- and fixation technique, postoperative restrictions, reoperation rates, study outcome score, rehabilitation program, and surgical complications was extracted. Ninety-six studies were identified with 18 studies being included in our analysis. The overall quality of the literature was fair with no studies being graded as excellent. Data on preoperative evaluation and surgical technique, complication and reoperation rates, postoperative management and study outcome was extracted in order to create an overview of the current literature. The literature supports the use of the AMIC procedure as an effective treatment for osteochondral lesions of talus. Great heterogeneity exists and comparative studies are missing. While the number of studies on the topic is increasing further are needed and especially with optimized design.
距骨骨软骨损伤是一种常见的损伤，在非手术治疗失败或病变移位的情况下需要手术治疗。许多研究已经对 AMIC 手术的有效性进行了研究。我们的研究目的是对当前文献进行综述。根据 PRISMA 指南，我们于 2020 年 5 月 27 日在 PubMed（MEDLINE）和 EMBASE 上进行了系统搜索。根据改良 Coleman 方法学评分评估所有纳入的研究，并提取研究类型、患者数量、年龄、随访时间、病变分级、位置和大小、研究纳入和排除标准、相关手术、手术技术、支架和固定技术、术后限制、再次手术率、研究结果评分、康复方案和手术并发症等信息。共确定了 96 项研究，其中 18 项研究纳入我们的分析。文献的总体质量为中等，没有研究被评为优秀。为了对当前文献进行综述，我们提取了术前评估和手术技术、并发症和再次手术率、术后管理和研究结果的数据。文献支持 AMIC 手术作为治疗距骨骨软骨损伤的有效方法。但存在很大的异质性，且缺乏比较性研究。虽然关于该主题的研究数量在不断增加，但还需要更多的研究，特别是需要优化设计的研究。
