Arceri Alberto, Mazzotti Antonio, Zielli Simone, Bonelli Simone, Artioli Elena, Abdi Pejman, Langone Laura, Faldini Cesare
1st Orthopaedics and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123, Bologna, Italy.
J Orthop. 2023 Sep 2;44:57-65. doi: 10.1016/j.jor.2023.09.001. eCollection 2023 Oct.
Technological developments and implants newer generation allowed to expand the indications for total ankle arthroplasty (TAA) with aim to maintain active lifestyles. This systematic review and meta-analysis examined chance of return to sport, achievable activity level, the type of patients and the sport type after TAA.
A literature search of PubMed, Scopus, and Cochrane databases was performed. Meta-analysis was performed if the same outcomes scores were reported at least by 4 studies. PRISMA guidelines were used. Risk of bias was assessed through the MINORS criteria. Included studies reported data and outcomes related to sport in patients undergoing TAA.
Initial search results yielded 483 articles; 11 articles were included in the review process. The chance to return to sport increases after TAA, achieving a mean sport participation rate of 61.9% postoperatively. Until to 92% of patients was able to return to their preoperative level of activity. Meta-analysis showed a significant postoperative improvement in the most represented outcomes scores. Especially, young, male, with lower BMI, and affected by non-inflammatory osteoarthritis were those who returned to sport reporting significantly better outcomes scores. The most frequent postoperative sports included cycling, swimming, hiking and gymnastic. Only few patients practiced impact sport.
Current literature does not allow to advise TAA for young and active patient who want to play sports after surgery. Selected patients undergoing TAA can return to sport after surgery, and the most approachable activities are low demanding sport. However, no strong evidence is available to support these findings. Further prospective randomized studies are necessary to establish more accurate expectations concerning sport activity after TAA implantation.
Level II, systematic review.
技术发展和新一代植入物使得全踝关节置换术（TAA）的适应症得以扩大，旨在维持积极的生活方式。本系统评价和荟萃分析研究了TAA术后恢复运动的机会、可达到的活动水平、患者类型和运动类型。
对PubMed、Scopus和Cochrane数据库进行文献检索。如果至少有4项研究报告了相同的结局评分，则进行荟萃分析。采用PRISMA指南。通过MINORS标准评估偏倚风险。纳入的研究报告了TAA患者与运动相关的数据和结局。
初步检索结果产生483篇文章；11篇文章纳入综述过程。TAA术后恢复运动的机会增加，术后平均运动参与率达到61.9%。高达92%的患者能够恢复到术前的活动水平。荟萃分析显示，在最具代表性的结局评分中，术后有显著改善。特别是，年轻、男性、BMI较低且受非炎性骨关节炎影响的患者恢复运动后的结局评分明显更好。最常见的术后运动包括骑自行车、游泳、徒步旅行和体操。只有少数患者进行冲击性运动。
目前的文献不建议对术后想进行运动的年轻活跃患者进行TAA。接受TAA的特定患者术后可以恢复运动，最适合的活动是低需求运动。然而，没有强有力的证据支持这些发现。需要进一步的前瞻性随机研究来建立关于TAA植入术后运动活动的更准确预期。
二级，系统评价。
