A network meta-analysis of the efficacy of arthrodesis with various fixation methods in the treatment of advanced ankle osteoarthritis

Wang, Ruoshi; Jing-dong, WU; Akhtyamov, I. F.; Зиатдинов, Б. Г.; Cai, Jianfei

doi:10.1016/j.injury.2023.05.025

Cited by 4 publications

(4 citation statements)

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“…Артродез ГСС -надежный метод лечения поздних стадий ОА ГСС, который эффективно снижает интенсивность боли и улучшает функцию пораженной конечности [4]. Успешность артродеза ГСС лежит в соблюдении нескольких ключевых принципов, включая адекватный костный контакт, межкостную компрессию и стабильность в области костного контакта [8,13].…”

Section: Discussionunclassified

“…человек [1,2]. В свою очередь, ОА голеностопного сустава составляет до 1 % [3][4][5], а классифицировать его можно на первичный и вторичный, в зависимости от этиологии первичной патологии. К причинам вторичного остеоартроза голеностопного сустава (ГСС) относятся травма, ревматоидный артрит, остеонекроз таранной кости, неудачные хирургические вмешательства, анатомическая деформация и т.п.…”

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“…Исходя из этого, мы считаем, что наиболее подходящий план хирургического лечения должен разрабатываться с учетом состояния пациента, включая его возраст, анамнез жизни, комплаентность пациента и т.д. и по принципу индивидуализации в сочетании с клиническим обследованием и визуализацией[4,10].ЗАКЛЮЧЕНИЕЭффективность артродеза ГСС при лечении поздних стадий ОА ГСС достаточно высока и позволяет значительно улучшить функцию пораженной конечности и уменьшить интенсивность боли в суставе.Каждый метод фиксации имеет свои преимущества и недостатки, но по долгосрочной эффективности значительной разницы нет, поэтому при выборе оптимального хирургического метода для достижения искомого результата следует соблюдать принцип индивидуального подхода.…”

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Evaluation of the effectiveness of ankle arthrodesis options

Wang,

Akhtiamov,

Cai

et al. 2024

jour

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Introduction Treatment methods for late stages of ankle osteoarthritis are varied, but the issue of assessing the long-term results of various fixation methods has not yet been studied, and this issue is of great importance in clinical practice.Purpose To compare the effectiveness of the fixation methods commonly used for ankle arthrodesis in patients with advanced ankle osteoarthritis.Materials and methods Eighty-two patients with advanced ankle osteoarthritis were treated with ankle fusion between 2019 and 2023 at three major medical institutions. All patients underwent 12-month follow-ups. The patients were divided into four groups depending on the method of surgical fixation of bone fragments.Results Most patients showed a significant improvement in the function and a decrease in pain intensity after the arthrodesis operation. The comparison of the effectiveness of various surgical fixation methods found that external apparatus screw fixation is characterized by lower blood loss and a relatively short duration of the operation. Plate and screw fixation resulted in higher AOFAS and VAS scores at 3 months postoperatively. However, by the 12th month after surgery, the differences in these two indicators were insignificant.Discussion Despite the various complications that occur in ankle arthrodesis, it remains effective for most patients. Among them, the Ilizarov apparatus is more suitable for patients with compromised conditions in the surgical area. Each method of surgical fixation has its own advantages and shortcomings, but the difference in long-term effectiveness is small. Conclusion Ankle arthrodesis is an effective treatment for advanced ankle osteoarthritis. The choice of surgical method is still subject to the principle of individual approach.

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Section: Discussionunclassified

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Evaluation of the effectiveness of ankle arthrodesis options

Wang,

Akhtiamov,

Cai

et al. 2024

jour

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“…From a technical point of view, AA can be performed using a number of fixation methods (such as cannulated screws, one or more plates, a nail or an external fixator) and following various strategies (arthroscopically-assisted procedures, use or not of bone or synthetic graft, one or two-stage procedures) depending on the specific case 3 , 5 – 10 . Surgeons usually rely on their experience and on the patient’s conditions in order to choose a fixation method to achieve the fusion of the ankle joint, since no technique has been proven more effective than another 11 , 12 .…”

Section: Introductionmentioning

confidence: 99%

Role of fibular autograft in ankle arthrodesis fixed using cannulated screws: a proportional meta-analysis and systematic review

Bernasconi,

Izzo,

D’Agostino

et al. 2023

Sci Rep

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Ankle arthrodesis is commonly performed to treat end-stage ankle osteoarthritis. The aim of this study was to determine whether the use of fibular autograft might increase the fusion rate and decrease the complication rate in ankle arthrodesis (AA) fixed using cannulated screws. To perform this PRISMA-compliant proportional meta-analysis, multiple databases were searched for studies in which patients undergone AA (using exclusively cannulated screws and augmented with fibular bone graft) were followed. The characteristics of the cohort, the study design, surgical details, the nonunion and complication rate at the longest follow-up were extracted and recorded. The modified Coleman Methodology Score (mCMS) was applied to appraise the quality of studies. Two groups were built: arthrodeses fixed with screws combined with cancellous autograft (G1) and arthrodeses fixed with screws combined with cancellous autograft and augmented with a lateral fibular onlay (G2). A third group (arthrodeses fixed with screws and no graft, G3) was extracted from previous literature for a further comparison. Overall, we included 306 ankles (296 patients) from ten series (ten studies). In G1 and G2 there were 118 ankles (111 patients) and 188 ankles (185 patients), respectively. In patients where cancellous autograft was used, a further augmentation with a fibular lateral strut autograft did not change significantly the nonunion (4% [95% CI 1–9] in G1 vs. 2% [95% CI 0–5) in G2, p = 0.99) nor the complication rate (18% [95% CI 0–36] in G1 vs. 13% [95% CI 6–21) in G2, p = 0.71). Upon comparison with 667 ankles (659 patients, G3) in which arthrodeses had been performed without grafting, the nonunion and complication rates did not differ significantly either (pooled estimates: 3% [95% CI 1–3) in G1 + G2 vs. 3% [95% CI 2–4] in G3, p = 0.73 for nonunion; 15% [8–23] in G1 + G2 vs. 13% [95% CI 9–17] in G3, p = 0.93 for complications). In ankle arthrodesis fixed with cannulated screws combined with cancellous autograft at the fusion site, a construct augmentation with a distal fibular onlay strut graft positioned laterally at the ankle joint does not reduce the risk of nonunion or complication. In general, the use of bone graft does not influence significantly the nonunion nor the complication rate as compared to non-grafted screw-fixed ankle arthrodeses.Kindly check and confirm the corresponding author mail id is correctly identified.It's all correct

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