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Abstract：
UNASSIGNED: Surgical treatment of symptomatic posterior ankle impingement consists of resection of the bony impediment and/or debridement of soft tissue. Historically, open techniques were used to perform surgery with good results. However, since the introduction of endoscopic techniques, advantages attributed to these techniques are shorter recovery time, fewer complications, and less pain.
UNASSIGNED: The primary purpose was to determine whether endoscopic surgery for posterior ankle impingement was superior to open surgery in terms of functional outcome (American Orthopaedic Foot & Ankle Society [AOFAS] score). The secondary aim was to determine differences in return to full activity, patient satisfaction, and complications.
UNASSIGNED: Systematic review and meta-analysis.
UNASSIGNED: MEDLINE, EMBASE (Classic), and CINAHL databases were searched. Publication characteristics, patient characteristics, surgical techniques, AOFAS scores, time to return to full activity, patient satisfaction, and complication rates were extracted. The AOFAS score was the primary outcome measure. Data were synthesized, and continuous outcome measures (postoperative AOFAS score and time to return to full activity) were pooled using a random-effects inverse variance method. Random-effects meta-analysis of proportions using continuity correction methods was performed to determine the proportion of patients who were satisfied and who experienced complications.
UNASSIGNED: A total of 32 studies were included in this review. No statistically significant difference was found in postoperative AOFAS scores between open surgery (88.0; 95% CI, 82.1-94.4) and endoscopic surgery (94.4; 95% CI, 93.1-95.7). There was no difference in the proportion of patients who rated their satisfaction as good or excellent, 0.91 (95% CI, 0.86-0.96) versus 0.86 (95% CI, 0.79-0.94), respectively. No significant difference in time to return to activity was found, 10.8 weeks (95% CI, 7.4-15.9 weeks) versus 8.9 weeks (95% CI, 7.6-10.4 weeks), respectively. Pooled proportions of patients with postoperative complications were 0.15 (95% CI, 0.11-0.19) for open surgery versus 0.08 (95% CI, 0.05-0.14) for endoscopic surgery. Without the poor-quality studies, this difference was statistically significant for both total and minor complications, 0.24 (95% CI, 0.14-0.35) versus 0.02 (95% CI, 0.00-0.06) and 0.14 (95% CI, 0.09-0.20) versus 0.03 (95% CI, 0.01-0.05), respectively.
UNASSIGNED: We found no statistically significant difference in postoperative AOFAS scores, patient satisfaction, and return to preinjury level of activity between open and endoscopic techniques. The proportion of patients who experienced a minor complication was significantly lower with endoscopic treatment when studies of poor methodological quality were excluded.
UNASSIGNED: The primary purpose was to determine whether endoscopic surgery for posterior ankle impingement was superior to open surgery in terms of functional outcome (American Orthopaedic Foot & Ankle Society [AOFAS] score). The secondary aim was to determine differences in return to full activity, patient satisfaction, and complications.
UNASSIGNED: Systematic review and meta-analysis.
UNASSIGNED: MEDLINE, EMBASE (Classic), and CINAHL databases were searched. Publication characteristics, patient characteristics, surgical techniques, AOFAS scores, time to return to full activity, patient satisfaction, and complication rates were extracted. The AOFAS score was the primary outcome measure. Data were synthesized, and continuous outcome measures (postoperative AOFAS score and time to return to full activity) were pooled using a random-effects inverse variance method. Random-effects meta-analysis of proportions using continuity correction methods was performed to determine the proportion of patients who were satisfied and who experienced complications.
UNASSIGNED: A total of 32 studies were included in this review. No statistically significant difference was found in postoperative AOFAS scores between open surgery (88.0; 95% CI, 82.1-94.4) and endoscopic surgery (94.4; 95% CI, 93.1-95.7). There was no difference in the proportion of patients who rated their satisfaction as good or excellent, 0.91 (95% CI, 0.86-0.96) versus 0.86 (95% CI, 0.79-0.94), respectively. No significant difference in time to return to activity was found, 10.8 weeks (95% CI, 7.4-15.9 weeks) versus 8.9 weeks (95% CI, 7.6-10.4 weeks), respectively. Pooled proportions of patients with postoperative complications were 0.15 (95% CI, 0.11-0.19) for open surgery versus 0.08 (95% CI, 0.05-0.14) for endoscopic surgery. Without the poor-quality studies, this difference was statistically significant for both total and minor complications, 0.24 (95% CI, 0.14-0.35) versus 0.02 (95% CI, 0.00-0.06) and 0.14 (95% CI, 0.09-0.20) versus 0.03 (95% CI, 0.01-0.05), respectively.
UNASSIGNED: We found no statistically significant difference in postoperative AOFAS scores, patient satisfaction, and return to preinjury level of activity between open and endoscopic techniques. The proportion of patients who experienced a minor complication was significantly lower with endoscopic treatment when studies of poor methodological quality were excluded.
摘要：
■对症后踝关节撞击的手术治疗包括切除骨性障碍和/或清除软组织。历史上,使用开放技术进行手术，效果良好。然而,自从引入内窥镜技术以来，这些技术的优点是恢复时间短，并发症少,更少的痛苦。
■主要目的是确定后踝关节撞击的内窥镜手术在功能结局方面是否优于开放手术（美国骨科足踝协会[AOFAS]评分）。次要目的是确定返回全部活动的差异，患者满意度,和并发症。
■系统评价和荟萃分析。
■MEDLINE,EMBASE(经典),和CINAHL数据库进行了搜索。出版物特征，患者特征,外科技术,AOFAS评分,时间回到完整的活动，患者满意度,并提取并发症发生率。AOFAS评分是主要结果指标。数据进行了综合，和连续结局指标(术后AOFAS评分和恢复到完全活动的时间)采用随机效应逆方差法进行汇总.使用连续性校正方法对比例进行随机效应荟萃分析，以确定满意和出现并发症的患者比例。
■本综述共纳入32项研究。开放手术（88.0；95％CI，82.1-94.4）和内镜手术（94.4；95％CI，93.1-95.7）之间的术后AOFAS评分无统计学差异。满意度评定为好或优的患者比例无差异,0.91（95%CI，0.86-0.96）与0.86（95%CI，0.79-0.94），分别。在恢复活动的时间上没有发现显著差异，10.8周（95%CI，7.4-15.9周）与8.9周（95%CI，7.6-10.4周），分别。开放手术术后并发症患者的合并比例为0.15（95％CI，0.11-0.19），而内窥镜手术为0.08（95％CI，0.05-0.14）。没有低质量的研究，这种差异对于总并发症和次要并发症都具有统计学意义，0.24（95%CI，0.14-0.35）对0.02（95%CI，0.00-0.06）和0.14（95%CI，0.09-0.20）对0.03（95%CI，0.01-0.05），分别。
■我们发现术后AOFAS评分无统计学差异，患者满意度,并恢复到开放和内窥镜技术之间的损伤前活动水平。当排除方法学质量差的研究时，内镜治疗中出现轻微并发症的患者比例明显较低。
■主要目的是确定后踝关节撞击的内窥镜手术在功能结局方面是否优于开放手术（美国骨科足踝协会[AOFAS]评分）。次要目的是确定返回全部活动的差异，患者满意度,和并发症。
■系统评价和荟萃分析。
■MEDLINE,EMBASE(经典),和CINAHL数据库进行了搜索。出版物特征，患者特征,外科技术,AOFAS评分,时间回到完整的活动，患者满意度,并提取并发症发生率。AOFAS评分是主要结果指标。数据进行了综合，和连续结局指标(术后AOFAS评分和恢复到完全活动的时间)采用随机效应逆方差法进行汇总.使用连续性校正方法对比例进行随机效应荟萃分析，以确定满意和出现并发症的患者比例。
■本综述共纳入32项研究。开放手术（88.0；95％CI，82.1-94.4）和内镜手术（94.4；95％CI，93.1-95.7）之间的术后AOFAS评分无统计学差异。满意度评定为好或优的患者比例无差异,0.91（95%CI，0.86-0.96）与0.86（95%CI，0.79-0.94），分别。在恢复活动的时间上没有发现显著差异，10.8周（95%CI，7.4-15.9周）与8.9周（95%CI，7.6-10.4周），分别。开放手术术后并发症患者的合并比例为0.15（95％CI，0.11-0.19），而内窥镜手术为0.08（95％CI，0.05-0.14）。没有低质量的研究，这种差异对于总并发症和次要并发症都具有统计学意义，0.24（95%CI，0.14-0.35）对0.02（95%CI，0.00-0.06）和0.14（95%CI，0.09-0.20）对0.03（95%CI，0.01-0.05），分别。
■我们发现术后AOFAS评分无统计学差异，患者满意度,并恢复到开放和内窥镜技术之间的损伤前活动水平。当排除方法学质量差的研究时，内镜治疗中出现轻微并发症的患者比例明显较低。
