Ankle Arthroscopy as an Adjunctive Method for Diagnosis of Nonunion After Tibiotalar Arthrodesis.
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ABSTRACT:
SUBMITTER: Cruz EP
PROVIDER: S-EPMC6928375 | biostudies-literature | 2019 Dec
REPOSITORIES: biostudies-literature
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Ankle Arthroscopy as an Adjunctive Method for Diagnosis of Nonunion After Tibiotalar Arthrodesis.
Arthroscopy techniques 20191120 12
The definition of consolidation after ankle arthrodesis can be challenging in some situations. Computed tomography has increased diagnostic accuracy; however, there are still no clear criteria for nonunion. In this context, arthroscopy with direct visualization of the arthrodesis may provide crucial data to inform the choice of treatment. The present report illustrates a case in which arthroscopy prompted a change in treatment strategy. More extensive surgery, with the potential for greater morb ...[more]
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Project description: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 4 English databases (PubMed, Embase, Medline and the Cochrane Library) from inception to February 2020. Three prospective cohort studies and 7 retrospective cohort studies, enrolling a total of 507 patients with ankle arthritis, were included. RESULTS: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, and shorter length of hospitalisation than open surgery.
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