Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
BMC Musculoskelet Disord. 2024 Jul 13;25(1):539. doi: 10.1186/s12891-024-07676-8.
All orthopaedic procedures, comprising foot and ankle surgeries, seemed to show a positive trend, recently. Bone grafts are commonly employed to fix bone abnormalities resulting from trauma, disease, or other medical conditions. This study specifically focuses on reviewing the safety and efficacy of various bone substitutes used exclusively in foot and ankle surgeries, comparing them to autologous bone grafts.
The systematic search involved scanning electronic databases including PubMed, Scopus, Cochrane online library, and Web of Science, employing terms like 'Bone substitute,' 'synthetic bone graft,' 'Autograft,' and 'Ankle joint.' Inclusion criteria encompassed RCTs, case-control studies, and prospective/retrospective cohorts exploring different bone substitutes in foot and ankle surgeries. Meta-analysis was performed using R software, integrating odds ratios and 95% confidence intervals (CI). Cochrane's Q test assessed heterogeneity.
This systematic review analyzed 8 articles involving a total of 894 patients. Out of these, 497 patients received synthetic bone grafts, while 397 patients received autologous bone grafts. Arthrodesis surgery was performed in five studies, and three studies used open reduction techniques. Among the synthetic bone grafts, three studies utilized a combination of recombinant human platelet-derived growth factor BB homodimer (rhPDGF-BB) and beta-tricalcium phosphate (β-TCP) collagen, while four studies used hydroxyapatite compounds. One study did not provide details in this regard. The meta-analysis revealed similar findings in the occurrence of complications, as well as in both radiological and clinical evaluations, when contrasting autografts with synthetic bone grafts.
Synthetic bone grafts show promise in achieving comparable outcomes in radiological, clinical, and quality-of-life aspects with fewer complications. However, additional research is necessary to identify the best scenarios for their use and to thoroughly confirm their effectiveness.
Level II.
最近，所有的骨科手术，包括足部和踝关节手术，似乎都呈现出积极的趋势。骨移植通常用于修复因创伤、疾病或其他医疗条件导致的骨骼异常。本研究专门回顾比较了专门应用于足部和踝关节手术的各种骨替代物的安全性和有效性，将其与自体骨移植物进行比较。
系统搜索包括扫描电子数据库，如 PubMed、Scopus、Cochrane 在线图书馆和 Web of Science，使用的术语有“骨替代物”、“合成骨移植物”、“自体移植物”和“踝关节”。纳入标准包括 RCTs、病例对照研究和前瞻性/回顾性队列研究，探讨足部和踝关节手术中不同的骨替代物。使用 R 软件进行 Meta 分析，整合优势比和 95%置信区间（CI）。Cochrane's Q 检验评估异质性。
本系统评价分析了 8 篇文章，共涉及 894 名患者。其中，497 名患者接受了合成骨移植物，397 名患者接受了自体骨移植物。5 项研究进行了关节融合术，3 项研究采用了切开复位技术。在合成骨移植物中，3 项研究使用了重组人血小板衍生生长因子 BB 同二聚体（rhPDGF-BB）和β-磷酸三钙（β-TCP）胶原的组合，4 项研究使用了羟磷灰石化合物。有一项研究未提供这方面的详细信息。Meta 分析显示，在比较自体移植物和合成骨移植物时，并发症的发生以及影像学和临床评估方面的结果相似。
合成骨移植物在影像学、临床和生活质量方面具有相似的效果，且并发症较少，具有良好的应用前景。然而，需要进一步的研究来确定其最佳使用场景，并充分证实其有效性。
二级。
