Saoji A, Arora M, Jain G, Shukla T
Department of Orthopedics, Datta Meghe Institute of Medical Sciences, Jawaharlal Nehru Medical College, Sawangi Meghe, Wardha, Maharashtra India.
Department of Orthopedics and Sports Medicine Fortis Hospital, Mohali, Punjab India.
Indian J Orthop. 2023 Sep 12;57(12):1993-1999. doi: 10.1007/s43465-023-00982-8. eCollection 2023 Dec.
Recently, peroneus longus (PL) autograft as a graft choice for ligament surgeries have attracted interest due to studies showing good clinical outcomes and minimal donor site morbidity. There remain concerns related to these grafts, especially the potential impact on ankle functions.
AIMS/OBJECTIVE: The purpose of this review and meta-analysis is to summarize the available evidence for ankle functional outcomes after PL harvest. This will provide objective clinical evidence for surgical decision making.
Cochrane, Embase, Medline, and Google Scholar were all searched for articles published between January 2001 and May 2021. For the aim of a systematic review, certain inclusion and exclusion criteria were adopted in accordance with PRISMA recommendations. The primary outcome measure was the assessment of ankle functional outcomes using validated instruments (such as AOFAS score, FADI score etc.).
A total of twelve studies representing pooled patient populations of 537 patients were included in this review. The average follow-up duration was 17 months (range; 6-32 months) across all studies. All twelve studies assessed AOFAS score and six studies also additionally assessed FADI score. The pooled mean outcomes measured showed a slight decrease in post-operative as compared to pre-operative AOFAS and FADI score (mean difference of AOFAS 1.92, 95% CI 1.021-3.123, value < 0.05 and mean difference for FADI 1.50, 95% CI 0.561-2.445, value < 0.05). Though statistically significant the magnitude of variance implies minimal clinical impact.
This review and meta-analysis found that PL autograft harvest leads to statistically significant but minimal impact on ankle functional outcomes. This, in conjunction with various studies on ankle parameters after PL harvest, shows that PL harvest leads to minimal impact on ankle outcomes and function.
Systematic review Level III.
最近，由于研究表明腓骨长肌（PL）自体移植作为韧带手术的移植物选择具有良好的临床效果且供区并发症极少，因而受到关注。但这些移植物仍存在一些问题，尤其是对踝关节功能的潜在影响。
本综述和荟萃分析的目的是总结腓骨长肌取材后踝关节功能结局的现有证据。这将为手术决策提供客观的临床依据。
检索了Cochrane、Embase、Medline和谷歌学术数据库中2001年1月至2021年5月发表的文章。为了进行系统综述，根据PRISMA指南采用了特定的纳入和排除标准。主要结局指标是使用经过验证的工具（如美国足踝外科协会（AOFAS）评分、足踝功能障碍指数（FADI）评分等）评估踝关节功能结局。
本综述纳入了12项研究，共涉及537例患者。所有研究的平均随访时间为17个月（范围：6 - 32个月）。所有12项研究均评估了AOFAS评分，6项研究还额外评估了FADI评分。汇总的平均测量结果显示，与术前相比，术后AOFAS和FADI评分略有下降（AOFAS平均差值为1.92，95%置信区间为1.021 - 3.123，P值<0.05；FADI平均差值为1.50，95%置信区间为0.561 - 2.445，P值<0.05）。虽然差异具有统计学意义，但差异程度意味着临床影响极小。
本综述和荟萃分析发现，腓骨长肌自体取材对踝关节功能结局有统计学意义但影响极小。这与腓骨长肌取材后关于踝关节参数的各种研究一起表明，腓骨长肌取材对踝关节结局和功能的影响极小。
系统综述III级。
