Background

This study aimed to evaluate the use of distraction arthroplasty for ankle osteoarthritis, with respect to patient reported outcome measures (PROMs), complications, range of motion and radiographic outcomes.

Methods

A computer-based search was performed in PubMed, Cinahl, Embase, Scopus and ISI Web of Science. Two reviewers independently performed title/abstract and full-text screening. Quality assessment was performed using The Methodological Index for Non-Randomised Studies (MINORS) and Joanna Briggs Institute criteria.

Results

Whilst all studies evaluating PROMs reported significant (P < 0.05) improvement, these were either below or only slightly above the minimally clinically important difference. The rate of conversion to arthrodesis or total ankle arthroplasty was high, with failure rates of up to 52% reported.

Conclusion

Due to the inconsistent improvements in PROMs, which are likely overestimated due to substantial bias, and the high failure rate, this review suggests that distraction arthroplasty is not currently an effective treatment option for ankle arthritis.

Level of evidence

Level IV, systematic review of level I to IV studies.

中文翻译：

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牵引关节成形术治疗踝关节骨性关节炎：系统评价

背景

本研究旨在评估牵引关节成形术在治疗踝关节骨性关节炎方面的应用，包括患者报告结果测量 (PROM)、并发症、活动范围和影像学结果。

方法

在 PubMed、Cinahl、Embase、Scopus 和 ISI Web of Science 中进行了基于计算机的检索。两名审稿人独立进行标题/摘要和全文筛选。使用非随机研究方法学指数 (MINORS) 和 Joanna Briggs Institute 标准进行质量评估。

结果

虽然所有评估 PROM 的研究都报告了显着 (P < 0.05) 的改善，但这些改善低于或仅略高于最低临床重要差异。关节固定术或全踝关节置换术的转化率很高，据报道失败率高达 52%。

结论

由于 PROMs 的改善不一致，这可能由于大量偏差而被高估，并且失败率很高，该综述表明牵引关节成形术目前不是踝关节炎的有效治疗选择。

证据等级

IV 级，对 I 至 IV 级研究的系统评价。