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Comparison of the Efficiency and Safety of Total Ankle Replacement and Ankle Arthrodesis in the Treatment of Osteoarthritis: An Updated Systematic Review and Meta‐analysis
- Source :
- Orthopaedic Surgery, Vol 12, Iss 2, Pp 372-377 (2020), Orthopaedic Surgery
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- While osteoarthritis is a common degenerative disease, ankle osteoarthritis is a subdivision that has received little attention. Two effective ways to treat osteoarthritis of the ankle are total ankle replacement (TAR) and ankle arthrodesis (AAD). Whether TAR or AAD is more beneficial for treatment is controversial. The purpose of this meta‐analysis was to compare the efficiency (clinical outcome and patient satisfaction) and safety (complications and survival) of these two procedures. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement was performed as a guideline for this study. Three electronic databases, PubMed, Web of Science, and Cochrane Library, were searched up to May 2019, with no language restrictions. Prospective or retrospective comparative studies were identified. The outcomes included clinical outcome, patient satisfaction, complications, and survival. Review Manager (Revman) 5.3 software was used to conduct the data analysis. We only selected literature from the past 5 years (no earlier than 2015). Seven comparative studies were included. There were six cohort studies and one cross‐sectional study. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of cohort studies, and The Agency for Healthcare Research and Quality (AHRQ) checklist was chosen to assess the quality of cross‐sectional studies. No significant difference was observed for efficiency and safety. Clinical outcome was included in five studies with four different scoring systems. Two of them used the American Orthopaedic Foot & Ankle Society (AOFAS) questionnaire scores to assess the two procedures (mean difference, −4.26; 95% confidence interval [CI], −11.37–2.85; P = 0.24; I 2 = 1%). Patient satisfaction (risk ratio [RR], 0.96; 95% CI, 0.65–1.40; P = 0.82; I 2 = 54%), complications (RR, 1.15; 95% CI, 0.16–8.21; P = 0.89; I 2 = 84%), and survival (RR, 1.91; 95% CI, 0.33–11.08; P = 0.47; I 2 = 90%) showed no significant difference between the TAR group and the AAD group. This meta‐analysis showed no statistically significant difference between TAR and AAD in clinical outcome, patient satisfaction, complications, and survival. This revealed that TAR and AAD could appear to have similar results in these aspects. Therefore, the present results are not sufficient to conclude which of these two methods is better. Further studies are needed to obtain more clues.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Ankle replacement
Arthrodesis
Review Article
Cochrane Library
03 medical and health sciences
Arthroplasty, Replacement, Ankle
0302 clinical medicine
Patient satisfaction
lcsh:Orthopedic surgery
Osteoarthritis
medicine
Humans
Orthopedics and Sports Medicine
Review Articles
Total Ankle Replacement
AAD
030222 orthopedics
business.industry
Ankle Arthrodesis
lcsh:RD701-811
medicine.anatomical_structure
Systematic review
Treatment Outcome
Patient Satisfaction
Meta-analysis
Relative risk
Physical therapy
Meta‐analysis
TAR
Surgery
Ankle
business
030217 neurology & neurosurgery
Ankle Joint
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 17577853 and 17577861
- Volume :
- 12
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Orthopaedic Surgery
- Accession number :
- edsair.doi.dedup.....f036c430dea7689cf49c5204b6434e2a