全踝关节置换术与踝关节融合术治疗踝关节骨关节炎的安全性和疗效：系统评价和荟萃分析。
Safety and efficacy of total ankle arthroplasty versus ankle arthrodesis for ankle osteoarthritis: A systematic review and meta-analysis.
机构信息
Faculty of Medicine, University of Jordan, Amman, Jordan.
Faculty of Medicine, Minia University, Minia, Egypt.
出版信息
Foot (Edinb). 2023 May;55:101980. doi: 10.1016/j.foot.2023.101980. Epub 2023 Feb 17.
Osteoarthritis is the most common joint disease-causing pain and disability, and its management keeps creating a debate. So, we aimed to compare the safety and efficacy of total ankle arthroplasty and ankle arthrodesis for ankle osteoarthritis. We searched PubMed, Cochrane, Scopus, and Web of Science till August 2021. The outcomes were pooled as Mean difference (MD) or Risk Ratio (RR), and 95% confidence interval. We included 36 studies. The results showed a significantly lower risk of infections in total ankle arthroplasty (TAA) than ankle arthrodesis (AA) (RR= 0.63, 95% CI [0.57, 0.70], p < 0.00001), amputations (RR= 0.40, 95% CI [0.22, 0.72], p = 0.002), postoperative non-union (RR= 0.11, 95% CI [0.03, 0.34], p = 0.0002), and a significant increase of overall range of motion in TAA than AA. Our results preferred total ankle arthroplasty over ankle arthrodesis in terms of lowering the rates of infections, amputations, and postoperative non-union, with better change in the overall range of motion.
骨关节炎是最常见的关节疾病，可导致疼痛和残疾，其治疗方法一直存在争议。因此，我们旨在比较全踝关节置换术和踝关节融合术治疗踝关节骨关节炎的安全性和疗效。我们检索了 PubMed、Cochrane、Scopus 和 Web of Science，检索时间截至 2021 年 8 月。将结局指标合并为均数差（MD）或风险比（RR），95%置信区间。我们共纳入了 36 项研究。结果表明，全踝关节置换术（TAA）的感染风险明显低于踝关节融合术（AA）（RR=0.63，95%CI[0.57,0.70]，p<0.00001）、截肢（RR=0.40，95%CI[0.22,0.72]，p=0.002）、术后非愈合（RR=0.11，95%CI[0.03,0.34]，p=0.0002），且 TAA 的整体活动范围明显大于 AA。我们的研究结果表明，在降低感染、截肢和术后非愈合的发生率方面，TAA 优于 AA，整体活动范围的改善更好。
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