Ankle arthrodesis—Open versus arthroscopic: A systematic review and meta-analysis

Chandrappa, Mallikarjun Honnenahalli; Hajibandeh, Shahin

doi:10.1016/j.jcot.2017.03.010

Cited by 31 publications

(33 citation statements)

References 18 publications

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“…Regarding the rate of fusion, the meta-analysis showed that there was a remarkable difference between arthroscopic arthrodesis and open surgery, and the data support the most recent meta-analysis by Honnenahalli et al [3] Patients who underwent arthroscopic arthrodesis had a higher fusion rate than those who underwent open surgery. In arthroscopic arthrodesis, the soft tissue envelope is disrupted to a minimum degree, which enables the major functions of soft tissues close to the surgical site.…”

Section: Inferences and Implicationssupporting

confidence: 70%

“…First, it was noted that there was no significant difference in days to union, which is contrary to previous studies. [3] Patients who underwent arthroscopic arthrodesis did not have a shorter time to union than those who experienced open surgery.…”

Section: Strength Of the Systematic Reviewmentioning

confidence: 93%

“…Arthrodesis is one of the last options for patients when conservative treatment fails. [3,4] Arthrodesis, via open surgery, is the traditional option for treating ankle arthritis, chronic instability, and degenerative deformity. [5] Pain relief and functional improvement of a foot with ankle degeneration are reasons why ankle arthrodesis might be highly recommended as a reliable treatment.…”

Section: Introductionmentioning

confidence: 99%

“…[12] However, to our knowledge, only one systematic review and meta-analysis comparing the outcomes of open and arthroscopic methods of ankle fusion is available in the literature, but it did not contain data on postoperative improvement. [3] This study evaluated the fusion rate, effectiveness, complications, and operative improvements by performing a systematic and meta-analysis that focused on all studies that met our criteria: studies were comparing arthroscopic arthrodesis and open surgery for patients with ankle arthritis.…”

Section: Introductionmentioning

confidence: 99%

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Open versus arthroscopic ankle arthrodesis: A systematic review and meta-analysis

Mok¹,

He²,

Panneerselvam³

et al. 2020

Preprint

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Background: Osteoarthritis (OA) is a growing health concern that affects approximately 27 million people in the USA and is associated with a $185 billion annual cost burden . Choosing between open surgery and arthroscopic arthrodesis for ankle arthritis is still controversial. This study compared arthroscopic arthrodesis and open surgery by performing a systematic review and meta-analysis. Methods: For the systematic review, a literature search was conducted in four English databases (PubMed, Embase, Medline and the Cochrane Library) from inception to February 2020. Two prospective cohort studies and 8 retrospective cohort studies, enrolling a total of 548 patients with ankle arthritis, were included. Result: For fusion rate, the pooled data showed a significantly higher rate of fusion during arthroscopic arthrodesis compared with open surgery (odds ratio 0.25, 95% CI 0.11 to 0.57, p = 0.0010). Regarding estimated blood loss, the pooled data showed significantly less blood loss during arthroscopic arthrodesis compared with open surgery (WMD 52.04, 95% CI 14.14 to 89.94, p = 0.007). For tourniquet time, the pooled data showed a shorter tourniquet time during arthroscopic arthrodesis compared with open surgery (WMD 22.68, 95% CI 1.92 to 43.43, p = 0.03). For length of hospital stay, the pooled data showed less hospitalisation time for patients undergoing arthroscopic arthrodesis compared with open surgery (WMD 1.62, 95% CI 0.97 to 2.26, p < 0.00001). The pooled data showed better recovery for the patients who underwent arthroscopic arthrodesis compared with open surgery at 1 year (WMD 14.73, 95% CI 6.66 to 22.80, p = 0.0003). Conclusion: In conclusion, arthroscopic arthrodesis was associated with a higher fusion rate, smaller estimated blood loss, shorter tourniquet time, shorter length of hospitalisation and better functional improvement at 1 year than open surgery.

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Section: Inferences and Implicationssupporting

confidence: 70%

Section: Strength Of the Systematic Reviewmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Open versus arthroscopic ankle arthrodesis: A systematic review and meta-analysis

Mok¹,

He²,

Panneerselvam³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Honnenahalli et al demonstrates that arthroscopic ankle fusion may be associated with a higher fusion rate, shorter tourniquet time, and shorter length of stay compared to open ankle fusion [20].…”

Section: Discussionmentioning

confidence: 99%

Outcome Comparison of Arthroscopic versus Mini-open Technique for Ankle Arthrodesis

Wang

et al. 2020

Preprint

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Background Ankle arthrodesis is considered to be the gold standard for the treatment of end-stage ankle diseases. At present, the commonly used methods of ankle arthrodesis include open ankle arthrodesis, arthroscopic ankle arthrodesis and mini-open ankle arthrodesis. The authors analyze and compare the clinical efficacy and related complications of arthroscopic ankle arthrodesis and mini-open ankle arthrodesis in the treatment of end-stage ankle disease. Methods From January 2007 to June 2018, 56 patents with end-stage ankle joint pathology were treated with arthroscopic ankle arthrodesis and mini-open ankle arthrodesis. There were 30 cases in arthroscopy group, including 19 males and 11 females with an average age of 49.6 years old (ranged, 32 to 71); while 26 cases in mini-open group, including 18 males and 8 females with an average age of 48.3 years old (ranged, 43 to 65). The operative time was calculated with use of computerized operative and anesthetic records. The pain visual analogue score (VAS), American Orthopedic Foot ༆ Ankle Society ankle and hind foot score (AOFAS), fusion rate, complications rate, length of hospital stay, operation time, and tourniquet time were compared between the two groups of patients. Results 51 patients were followed up for 15–35 months (mean, 22.5 ± 1.5) months. The bony fusion was achieved in all patients. The average time to fusion was 12.4 weeks (range, 10–16 weeks). The VAS score 3 days post-operation was (6.37 ± 0.69) points in the arthroscopy group and (7.61 ± 1.05) points in the mini-open group, there was significant difference between the two groups (P < 0.05). The VAS score and AOFAS score between the two groups pre- and post-operation have statistically significant differences (P < 0.05). At the last follow-up, VAS score was (1.55 ± 0.57) in the arthroscopy group and (1.43 ± 0.73) in the mini-open group, and there was no significant difference between the two groups (P > 0.05). The AOFAS score was (85.32 ± 2.96) points in the arthroscopy group and (86.72 ± 3.05) points in the mini-open group, and there was no significant difference between the two groups (P > 0.05). Arthroscopic ankle fusion was associated with a shorter tourniquet time and shorter length of hospital stay compared to mini-open ankle fusion (P < 0.05); however, there was no significant difference between two groups in terms of operation time (P > 0.05). Wounds healing was satisfying during the follow-up in the arthroscopy group. But the wounds healing was delayed in two patients of the small incision group. All patients were satisfied with the surgery. Conclusion Arthroscopic ankle arthrodesis and mini-open ankle arthrodesis have satisfactory curative effect and fusion rate. Arthroscopic assisted ankle arthrodesis has more advantages, including small incision, less injury, and low morbidity.

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Excellent clinical and radiological outcomes after arthroscopic reduction and double row‐suture bridge for large‐sized greater tuberosity fractures of the humerus

Ko,

Oh,

Park

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeCurrently, there is limited information on the clinical outcomes of arthroscopic reduction and double‐row suture bridge fixation for large greater tuberosity fractures of the proximal humerus. This study aimed to evaluate the radiological and clinical outcomes of arthroscopic reduction and double‐row suture bridge fixation for these fractures, hypothesizing that arthroscopic reduction and double‐row suture bridge fixation is a safe, effective and minimally invasive treatment for large greater tuberosity fractures.MethodsThis retrospective study analysed patients with large greater tuberosity fractures (fracture fragment ≥30 mm in diameter) who underwent arthroscopic reduction and double‐row suture bridge fixation and had a follow‐up period exceeding 2 years. The anatomic reduction was confirmed by assessing the step‐off on radiographs immediately after surgery, and the radiologic union time was recorded. At the final follow‐up, range of motion and functional outcome scores were evaluated. Additionally, any surgery‐related complications were evaluated.ResultsFifteen patients with a mean follow‐up of 57.7 ± 23.1 months were included in the study. The mean fracture fragment size was 32.5 ± 2.4 mm, with a mean displacement of 5.1 ± 1.6 mm. Immediately postsurgery, 13 of 15 patients (86.7%) had a fracture step‐off of <3 mm, with an average union time of 3 months. At the final follow‐up, patients demonstrated excellent outcomes, with an average forward flexion of 167 ± 9.7° and external rotation of 70 ± 16.3. Functional outcome scores showed significant improvement compared with preoperative scores (p < 0.001). No major surgery‐related complications were reported.ConclusionsArthroscopic reduction and double‐row suture bridge fixation for large‐sized greater tuberosity fractures is safe and shows good fracture reduction and excellent clinical outcomes. Therefore, this surgical method can be considered an alternative to open reduction for large greater tuberosity fractures.Level of EvidenceLevel IV.

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Ankle arthrodesis—Open versus arthroscopic: A systematic review and meta-analysis

Cited by 31 publications

References 18 publications

Open versus arthroscopic ankle arthrodesis: A systematic review and meta-analysis

Open versus arthroscopic ankle arthrodesis: A systematic review and meta-analysis

Outcome Comparison of Arthroscopic versus Mini-open Technique for Ankle Arthrodesis

Excellent clinical and radiological outcomes after arthroscopic reduction and double row‐suture bridge for large‐sized greater tuberosity fractures of the humerus

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