PDF(Pubmed)
Abstract：
This systematic review aims to investigate the efficacy of non-surgical interventions for midfoot osteoarthritis (OA). Key databases and trial registries were searched from inception to 23 February 2023. All trials investigating non-surgical interventions for midfoot OA were included. Quality assessment was performed using the National Institutes of Health Quality Assessment Tool. Outcomes were pain, function, health-related quality of life, and adverse events. Effects (mean differences, standardised mean differences, risk ratios) were calculated where possible for the short (0 to 12 weeks), medium (> 12 to 52 weeks), and long (> 52 weeks) term. Six trials (231 participants) were included (one feasibility trial and five case series) - all were judged to be of poor methodological quality. Two trials reported arch contouring foot orthoses to exert no-to-large effects on pain in the short and medium term, and small-to-very-large effects on function in the short and medium term. Two trials reported shoe stiffening inserts to exert medium-to-huge effects on pain in the short term, and small effects on function in the short term. Two trials of image-guided intra-articular corticosteroid injections reported favourable effects on pain in the short term, small effects on pain and function in the medium term, and minimal long term effects. Two trials reported minor adverse events, and none reported health-related quality of life outcomes. The current evidence suggests that arch contouring foot orthoses, shoe stiffening inserts and corticosteroid injections may be effective for midfoot OA. Rigorous randomised trials are required to evaluate the efficacy of non-surgical interventions for midfoot OA.
摘要：
本系统评价旨在探讨非手术干预对中足骨关节炎（OA）的疗效。从开始到2023年2月23日检索了关键数据库和试验登记处。包括所有研究非手术干预治疗中足OA的试验。使用美国国立卫生研究院质量评估工具进行质量评估。结果是痛苦，函数,与健康相关的生活质量，和不良事件。影响(平均差异，标准化平均差异，风险比)在可能的情况下计算短期(0至12周)，中等（>12至52周），和长期（>52周）。纳入了6项试验（231名参与者）（1项可行性试验和5项病例系列），均被认为方法学质量较差。两项试验报告足弓矫形器在短期和中期对疼痛产生无至大的影响，以及在短期和中期对功能的小到非常大的影响。两项试验报告说，鞋子加强插入物在短期内对疼痛产生中等到巨大的影响，短期内对功能的影响很小。两项图像引导关节内注射皮质类固醇的试验报道了短期内对疼痛的有利影响，在中期对疼痛和功能的影响很小，和最小的长期影响。两项试验报告了轻微的不良事件，没有报告健康相关的生活质量结局.目前的证据表明足弓矫形器，加强鞋垫和皮质类固醇注射可能对中足OA有效。需要严格的随机试验来评估非手术干预对中足OA的疗效。
