Arceri Alberto, Abdi Pejman, Mazzotti Antonio, Zielli Simone Ottavio, Artioli Elena, Langone Laura, Sgubbi Federico, Faldini Cesare
1st Orthopaedics and Traumatologic Clinic, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy.
J Pers Med. 2024 Jul 19;14(7):770. doi: 10.3390/jpm14070770.
This retrospective study aims to compare surgical outcomes between two cohorts of patients who underwent total ankle arthroplasty (TAA) using either standard technique or patient-specific instrumentation (PSI).
A consecutive series of patients who affected of end-staged ankle osteoarthritis were retrospectively assessed and divided into two groups based on TAA techniques: a TAA standard technique group and a TAA-using PSI group. The two groups were compared in terms of operative time, additional procedures, complications (neurovascular and wound problems, infection, loosening and osteolysis, revision and explantation rates, and perioperative fracture), clinical scores, and range of motion (ROM).
Fifty-one patients underwent standard TAA, while 13 patients underwent TAA with PSI. At 1-year follow-up, there were no significant differences in complication rates between the two groups ( > 0.05). AOFAS scores were similar, with the standard TAA group scoring 83.33 ± 7.55 and the PSI group scoring 82.92 ± 9.7 ( = 0.870). Likewise, the postoperative ROM did not differ significantly, with 15.12 ± 7.6 degrees for the standard TAA group and 16.05 ± 6.7 degrees for the PSI group ( = 0.689). However, the standard TAA group experienced significantly longer operative time (107.1 ± 22.1 min) compared to the PSI group (91.92 ± 22.9 min, = 0.032). Additionally, the standard TAA group required more adjunctive procedures (29.7%) compared to the PSI group (7.7%, = 0.04). Residual pain was also more frequently reported in the standard TAA group (62.7%) than in the PSI group (30.7%, = 0.038).
While both techniques resulted in comparable complication rates, clinical scores and ROM, the PSI group reported significantly shorter operative time and less residual pain, thus requiring fewer postoperative procedures.
本回顾性研究旨在比较两组接受全踝关节置换术（TAA）的患者的手术结果，这两组患者分别采用标准技术或定制器械（PSI）。
对一系列连续性的终末期踝关节骨关节炎患者进行回顾性评估，并根据TAA技术分为两组：TAA标准技术组和使用PSI的TAA组。比较两组的手术时间、附加手术、并发症（神经血管和伤口问题、感染、松动和骨溶解、翻修和取出率以及围手术期骨折）、临床评分和活动范围（ROM）。
51例患者接受了标准TAA，13例患者接受了使用PSI的TAA。在1年随访时，两组并发症发生率无显著差异（>0.05）。美国足踝外科协会（AOFAS）评分相似，标准TAA组评分为83.33±7.55，PSI组评分为82.92±9.7（=0.870）。同样，术后ROM差异不显著，标准TAA组为15.12±7.6度，PSI组为16.05±6.7度（=0.689）。然而，与PSI组（91.92±22.9分钟，=0.032）相比，标准TAA组的手术时间明显更长（107.1±22.1分钟）。此外，标准TAA组需要更多的辅助手术（29.7%），而PSI组为（7.7%，=0.04）。标准TAA组残留疼痛的报告频率也高于PSI组（62.7%对30.7%，=0.038）。
虽然两种技术的并发症发生率、临床评分和ROM相当，但PSI组的手术时间明显更短，残留疼痛更少，因此术后所需手术更少。
