Lorente Alejandro, Pelaz Leire, Palacios Pablo, Bautista Iker J, Mariscal Gonzalo, Barrios Carlos, Lorente Rafael
Ankle and Foot Surgery Unit, Department of Traumatology and Orthopaedic Surgery, University Hospital Ramón y Cajal, 28034 Madrid, Spain.
Department of Traumatology and Orthopaedic Surgery, Sanchinarro University Hospital, 28050 Madrid, Spain.
J Clin Med. 2023 May 20;12(10):3574. doi: 10.3390/jcm12103574.
Although open surgery is the conventional option for ankle arthritis, there are some reports in the literature regarding the use of the arthroscopy procedure with outstanding results. The primary purpose of this systematic review and meta-analysis was to analyze the effect of the surgery technique (open-ankle arthrodesis vs. arthroscopy) in patients with ankle osteoarthritis. Three electronic databases (PubMed, Web of Science, and Scopus) were searched until 10 April 2023. The Cochrane Collaboration's risk-of-bias tool was used to assess the risk of bias and grading of the recommendations assessment, development, and evaluation system for each outcome. The between-study variance was estimated using a random-effects model. A total of 13 studies (including = 994 participants) met the inclusion criteria. The meta-analysis results revealed a nom-significant ( = 0.072) odds ratio (OR) of 0.54 (0.28-1.07) for the fusion rate. Regarding operation time, a non-significant difference ( = 0.573) among both surgical techniques was found (mean differences (MD) = 3.40 min [-11.08 to 17.88]). However, hospital length stay and overall complications revealed significant differences (MD = 2.29 days [0.63 to 3.95], = 0.017 and OR = 0.47 [0.26 to 0.83], = 0.016), respectively. Our findings showed a non-statistically significant fusion rate. On the other hand, operation time was similar among both surgical techniques, without significant differences. Nevertheless, lower hospital stay was found in patients that were operated on with arthroscopy. Finally, for the outcome of overall complications, the ankle arthroscopy technique was a protective factor in comparison with open surgery.
尽管开放手术是踝关节关节炎的传统治疗选择，但文献中也有一些关于关节镜手术应用且效果出色的报道。本系统评价和荟萃分析的主要目的是分析手术技术（开放性踝关节融合术与关节镜手术）对踝关节骨关节炎患者的影响。检索了三个电子数据库（PubMed、科学网和Scopus）直至2023年4月10日。使用Cochrane协作网的偏倚风险工具评估每个结局的偏倚风险以及推荐评估、制定和评价系统的分级。采用随机效应模型估计研究间方差。共有13项研究（包括994名参与者）符合纳入标准。荟萃分析结果显示，融合率的优势比（OR）为0.54（0.28 - 1.07），差异无统计学意义（P = 0.072）。关于手术时间，两种手术技术之间未发现显著差异（P = 0.573）（平均差（MD）= 3.40分钟[-11.08至17.88]）。然而，住院时间和总体并发症分别显示出显著差异（MD = 2.29天[0.63至3.95]，P = 0.017；OR = 0.47[0.26至0.83]，P = 0.016）。我们的研究结果显示融合率无统计学显著差异。另一方面，两种手术技术的手术时间相似，无显著差异。然而，接受关节镜手术的患者住院时间较短。最后，对于总体并发症的结局，与开放手术相比，踝关节镜技术是一个保护因素。
