1999年至2023年间，接受全踝关节置换术患者的中位年龄没有显著变化：一项前瞻性研究的系统评价。

Median age of patients undergoing total ankle replacement has not significantly changed between 1999 and 2023: A systematic review of prospective studies.

作者信息

Bernasconi Alessio, Izzo Antonio, Sgadari Arianna, D'Agostino Martina, Mariconda Massimo, Goldberg Andrew J

机构信息

Department of Public Health, Trauma and Orthopaedics, University of Naples Federico II, Naples, Italy.

The Wellington Hospital, London, United Kingdom.

出版信息

Foot Ankle Surg. 2025 Jan;31(1):3-9. doi: 10.1016/j.fas.2024.07.007. Epub 2024 Jul 19.

DOI:10.1016/j.fas.2024.07.007

PMID:39069398

Abstract

INTRODUCTION

Total ankle replacement (TAR) is an effective treatment for end-stage osteoarthritis. The aim of this systematic review was to assess the age of patients undergoing TAR in prospective comparative studies. Our hypothesis is that the age reported in most recent papers might be lower than those reported in older papers.

METHODS

This systematic review was performed using Pubmed, Scopus, EMBASE and Cochrane databases. Only Level I and II studies dealing with TAR were included. Data regarding demographics, study design, number of cohorts in each study, year of publication and year/years in which surgery was performed were extracted. A two-fold analysis was conducted building groups of patients based on the year of publication and creating 1) two groups (before and after the median year) and 2) three groups (using tertiles) in order to compare age of patients operated in different period of times. A comparison was also performed considering the median year of surgery for patients undergoing TAR.

RESULTS

Overall 59 cohorts (42 studies, published between 1999 and 2023; median year of publication: 2017) were included (6397 ankles, 6317 patients, median age 63 years). The difference between the median age for 27 cohorts published until 2016 (weighted median 63 years; IQR, 62.5-64) and the median age for 32 cohorts published after 2017 (weighted median 63.2 years; IQR, 63-67.8) was not statistically significant (p = 0.09). The division in tertiles did not reveal any significant change in the weighted median age at surgery (T1 (1999-2014; 63.2 years; IQR, 62.8-64.1), T2 (2015-2018; 63 years; IQR,63-63.5) and T3 (2019-2023; 63.2 years; IQR, 62.6-67.8)) over time (p = 0.65). The median age of patients operated between 1999 and 2008 vs 2009 and 2023 (data from 48 cohorts) was not different either (p = 0.12).

CONCLUSION

According to this review of prospective studies published between 1999 and 2023, the median age for patients undergoing TAR over the last two decades has been 63 years, remaining steady with no significant changes over time.

LEVEL OF EVIDENCE

Level II - systematic review including Level I and Level II studies.

摘要

引言

全踝关节置换术（TAR）是终末期骨关节炎的一种有效治疗方法。本系统评价的目的是在前瞻性比较研究中评估接受TAR治疗的患者年龄。我们的假设是，最近论文中报道的年龄可能低于较早论文中报道的年龄。

方法

本系统评价通过使用PubMed、Scopus、EMBASE和Cochrane数据库进行。仅纳入了涉及TAR的I级和II级研究。提取了有关人口统计学、研究设计、每项研究中的队列数量、发表年份以及进行手术的年份的数据。进行了双重分析，根据发表年份将患者分组，创建1）两组（中位数年份之前和之后）和2）三组（使用三分位数），以便比较在不同时间段接受手术的患者年龄。还根据接受TAR治疗患者的手术中位数年份进行了比较。

结果

总共纳入了59个队列（42项研究，发表于1999年至2023年之间；发表中位数年份：2017年）（6397例踝关节，6317例患者，年龄中位数63岁）。2016年之前发表的27个队列的年龄中位数（加权中位数63岁；四分位间距，62.5 - 64）与2017年之后发表的32个队列的年龄中位数（加权中位数63.2岁；四分位间距，63 - 67.8）之间的差异无统计学意义（p = 0.09）。按三分位数划分未显示手术时加权中位数年龄有任何显著变化（T1（1999 - 2014年；63.2岁；四分位间距，62.8 - 64.1），T2（2015 - 2018年；63岁；四分位间距，63 - 63.5）和T3（2019 - 2023年；63.2岁；四分位间距，62.6 - 67.8））随时间的变化（p = 0.65）。1999年至2008年与2009年至2023年期间接受手术的患者年龄中位数（来自48个队列的数据）也无差异（p = 0.12）。