Li Yaxing, Zhang Hui
Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Jul 15;37(7):769-775. doi: 10.7507/1002-1892.202306039.
Ankle arthritis affects approximately 1% of the adult population worldwide and represents a serious global disease burden. However, compared with hip arthritis and knee arthritis, the clinical understanding and treatment of ankle arthritis are still in their infancy. For end-stage ankle arthritis, ankle arthrodesis was considered as the "gold standard" in the past. However, ankle arthrodesis will result in loss of joint mobility, altered gait, limited daily activities, and accelerated degeneration of adjacent joints. Therefore, how to preserve the range of motion of the ankle joint while relieving pain is the key to the treatment of ankle arthritis. Currently, the surgical treatment of ankle arthritis includes arthroscopic debridement, periarticular osteotomies, osteochondral transplantation, ankle distraction arthroplasty, ankle arthrodesis, and total ankle arthroplasty. The choice of treatment should be individualized and based on various factors such as the patient's symptoms, signs, imaging performance, complaints, and financial situation. However, there are no guidelines that give clear treatment recommendations. Therefore, it is necessary to conduct extensive and in-depth discussions on the diagnosis and treatment of ankle arthritis.
踝关节关节炎影响着全球约1%的成年人口,是一项严重的全球性疾病负担。然而,与髋关节炎和膝关节炎相比,踝关节关节炎的临床认识和治疗仍处于起步阶段。对于终末期踝关节关节炎,过去踝关节融合术被视为“金标准”。然而,踝关节融合术会导致关节活动度丧失、步态改变、日常活动受限以及相邻关节加速退变。因此,如何在缓解疼痛的同时保留踝关节的活动范围是踝关节关节炎治疗的关键。目前,踝关节关节炎的外科治疗包括关节镜清理术、关节周围截骨术、骨软骨移植术、踝关节撑开成形术、踝关节融合术以及全踝关节置换术。治疗方案的选择应个体化,并基于患者的症状、体征、影像学表现、诉求以及经济状况等多种因素。然而,目前尚无给出明确治疗建议的指南。因此,有必要就踝关节关节炎的诊断和治疗进行广泛而深入的讨论。