BACKGROUND A great deal of research suggests that arthroscopic ankle fusion (AAF) has advantages over open ankle fusion (OAF), but these outcomes would be imprecise because of a selection bias. The purpose of this study is to verify which is better for ankle fusion, AAF or OAF. We regrouped the OAF group into two subgroups according to whether the osseous operation type is the same as AAF group. The goal is to minimize the impact of disease severity, thereby reducing selection bias to some extent. METHODS We retrospectively analyzed the data of ankle fusion in our hospital between July 2015 and October 2018. Forty-three patients were enrolled and divided into AAF group (n = 17) and OAF group (n = 26). In order to eliminate selection bias, we divided OAF group into complex osseous operation subgroup (COO subgroup) (n = 15) and simple osseous operation subgroup (SOO subgroup) (n = 11). The osseous operation type of SOO subgroup is the same as AAF group. Then, we compared the differences between these groups. All patients were followed up at least 1 year after operation. We analyzed data, including etiology composition, surgical time, intra-op blood loss, reduction of albumin, total hospital stays, union time, fusion situation, complications, radiological examination, functional score, and questionnaire survey. Then we performed statistical analyses. RESULTS We found that the etiological components of AAF group and OAF group were different; the etiological components of AAF group and SOO subgroup were similar. We found that AAF group has advantages over OAF group and COO subgroup in general. However, except in terms of surgical trauma, hospital stays, and short-term complications occurred, the AAF group has not obvious advantages over SOO subgroup, including intra-op blood loss, fusion condition, postoperative function score, and postoperative patient satisfaction; and AAF group need more surgical time than the SOO subgroup. CONCLUSIONS The arthroscopic ankle fusion can bring a good curative effect; however, if the osseous operation type is the same, the arthroscopic ankle fusion only has a limited advantage over the traditional open operation in perioperative soft tissue protection and enhanced recovery after surgery.

中文翻译：

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如果骨性手术类型相同，则关节镜下踝关节融合术仅比开放性手术具有有限的优势：一项回顾性比较研究。

背景技术大量研究表明，关节镜下踝关节融合术（AAF）优于开放式踝关节融合术（OAF），但由于选择偏倚，这些结果可能不准确。这项研究的目的是验证哪种方法更适合踝关节融合，AAF或OAF。根据骨操作类型是否与AAF组相同，将OAF组重新分组为两个子组。目的是使疾病严重程度的影响最小化，从而在一定程度上减少选择偏见。方法回顾性分析2015年7月至2018年10月我院踝关节融合术的资料。共纳入43例患者，分为AAF组（n = 17）和OAF组（n = 26）。为了消除选择偏见，我们将OAF组分为复杂的骨操作子组（COO子组）（n = 15）和简单的骨操作子组（SOO子组）（n = 11）。SOO子组的骨性操作类型与AAF组相同。然后，我们比较了这两组之间的差异。术后至少1年对所有患者进行随访。我们分析了数据，包括病因组成，手术时间，术中失血，白蛋白减少，总住院时间，工会时间，融合情况，并发症，放射学检查，功能评分和问卷调查。然后我们进行了统计分析。结果发现AAF组和OAF组的病因不同。AAF组和SOO亚组的病因相似。我们发现，AAF组通常比OAF组和COO子组具有优势。然而，除了手术创伤，住院时间和发生短期并发症外，AAF组与SOO组相比没有明显优势，包括手术中失血，融合状况，术后功能评分和术后患者满意度。与AOO组相比，AAF组需要更多的手术时间。结论关节镜下踝关节融合可带来良好的疗效。但是，如果骨性手术类型相同，则关节镜下踝关节融合术在围手术期软组织保护和术后恢复性方面仅优于传统的开放式手术。AAF组与SOO组相比没有明显优势，包括手术中失血，融合状况，术后功能评分和术后患者满意度。与AOO组相比，AAF组需要更多的手术时间。结论关节镜下踝关节融合可带来良好的疗效。但是，如果骨性手术类型相同，则关节镜下踝关节融合术在围手术期软组织保护和术后恢复性方面仅优于传统的开放式手术。AAF组与SOO组相比没有明显优势，包括手术中失血，融合状况，术后功能评分和术后患者满意度。与AOO组相比，AAF组需要更多的手术时间。结论关节镜下踝关节融合可带来良好的疗效。但是，如果骨性手术类型相同，则关节镜下踝关节融合术在围手术期软组织保护和术后恢复性方面仅优于传统的开放式手术。