Abstract：
The subtalar joint has a complex anatomic function that includes inversion and eversion of the hindfoot, assisting in walking on uneven surfaces. Arthritis is the most common pathological condition affecting this joint and can require fusion. The surgery can be performed open or with arthroscopic assistance. This systematic review assesses articles written on the safety and efficacy of isolated arthroscopic subtalar fusion.
Using MEDLINE and Embase, we systematically reviewed articles published before May 21, 2020.
Of 395 articles, 17 on a total of 395 patients (409 operations) were included in the review. The average duration of follow-up was 40.0 months (range, 3 to 105 months). Radiographic evidence of union was reported for 95.8% of cases at an average of 11.9 weeks (range, 6 to 56 weeks) postoperatively. Delayed union was reported in 1.0% of patients and nonunion, in 4.3% of patients. In the articles reporting patient satisfaction, including pain relief, 95.4% of patients had positive outcomes. Postoperative complications were reported in 64 patients (16.2%), including 37 (9.4%) with symptomatic implants, 11 (2.8%) with dysesthesia or neuropathic pain, and 3 (0.8%) with postoperative infection.
Arthroscopic subtalar fusion is a safe and effective alternative to open subtalar arthrodesis, with high patient satisfaction rates, high union rates at similar follow-up intervals, and low complication rates. The aim of future research should be to determine the ideal cases for this approach as well as the most efficient arthroscopic surgical technique and postoperative rehabilitation to optimize function and union as seen on radiographs.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Using MEDLINE and Embase, we systematically reviewed articles published before May 21, 2020.
Of 395 articles, 17 on a total of 395 patients (409 operations) were included in the review. The average duration of follow-up was 40.0 months (range, 3 to 105 months). Radiographic evidence of union was reported for 95.8% of cases at an average of 11.9 weeks (range, 6 to 56 weeks) postoperatively. Delayed union was reported in 1.0% of patients and nonunion, in 4.3% of patients. In the articles reporting patient satisfaction, including pain relief, 95.4% of patients had positive outcomes. Postoperative complications were reported in 64 patients (16.2%), including 37 (9.4%) with symptomatic implants, 11 (2.8%) with dysesthesia or neuropathic pain, and 3 (0.8%) with postoperative infection.
Arthroscopic subtalar fusion is a safe and effective alternative to open subtalar arthrodesis, with high patient satisfaction rates, high union rates at similar follow-up intervals, and low complication rates. The aim of future research should be to determine the ideal cases for this approach as well as the most efficient arthroscopic surgical technique and postoperative rehabilitation to optimize function and union as seen on radiographs.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
摘要：
距下关节具有复杂的解剖功能，包括后足的内翻和外翻，帮助在不平坦的表面上行走。关节炎是影响该关节的最常见病理状况，可能需要融合。手术可以开放式或在关节镜辅助下进行。本系统综述评估了有关孤立性关节镜距下融合的安全性和有效性的文章。
使用MEDLINE和Embase，我们系统审查了2020年5月21日之前发表的文章。
在395篇文章中，共有395例患者（409例手术）中的17例被纳入审查。平均随访时间为40.0个月(范围,3至105个月）。平均11.9周，有95.8%的病例报告有愈合的影像学证据（范围，术后6至56周）。据报道，1.0％的患者和骨不连延迟愈合，4.3%的患者。在报告患者满意度的文章中，包括疼痛缓解,95.4%的患者有积极的结果。术后并发症64例（16.2%），包括37（9.4％）有症状的植入物，11（2.8％）有感觉异常或神经性疼痛，术后感染3例(0.8%)。
关节镜距下融合术是一种安全有效的开放性距下关节固定术的替代方法，患者满意度高，在相似的随访间隔内，工会率高，并发症发生率低。未来研究的目的应该是确定这种方法的理想病例，以及最有效的关节镜手术技术和术后康复，以优化X射线照片上的功能和结合。
治疗级别IV。有关证据级别的完整描述，请参阅作者说明。
使用MEDLINE和Embase，我们系统审查了2020年5月21日之前发表的文章。
在395篇文章中，共有395例患者（409例手术）中的17例被纳入审查。平均随访时间为40.0个月(范围,3至105个月）。平均11.9周，有95.8%的病例报告有愈合的影像学证据（范围，术后6至56周）。据报道，1.0％的患者和骨不连延迟愈合，4.3%的患者。在报告患者满意度的文章中，包括疼痛缓解,95.4%的患者有积极的结果。术后并发症64例（16.2%），包括37（9.4％）有症状的植入物，11（2.8％）有感觉异常或神经性疼痛，术后感染3例(0.8%)。
关节镜距下融合术是一种安全有效的开放性距下关节固定术的替代方法，患者满意度高，在相似的随访间隔内，工会率高，并发症发生率低。未来研究的目的应该是确定这种方法的理想病例，以及最有效的关节镜手术技术和术后康复，以优化X射线照片上的功能和结合。
治疗级别IV。有关证据级别的完整描述，请参阅作者说明。
