PDF(Pubmed)
Abstract：
BACKGROUND: Progressive collapsing foot deformity (PCFD), formally known as \"adult-acquired flatfoot deformity\" (AAFFD), is a complex foot deformity consisting of multiple components. If surgery is required, joint-preserving procedures, such as a medial displacement calcaneal osteotomy (MDCO), are frequently performed. The aim of this systematic review is to provide a summary of the evidence on the impact of MDCO on foot biomechanics.
METHODS: A systematic literature search across two major sources (PubMed and Scopus) without time limitation was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria. Only original research studies reporting on biomechanical changes following a MDCO were included. Exclusion criteria consisted of review articles, case studies, and studies not written in English. 27 studies were included and the methodologic quality graded according to the QUACS scale and the modified Coleman score.
RESULTS: The 27 included studies consisted of 18 cadaveric, 7 studies based on biomechanical models, and 2 clinical studies. The impact of MDCO on the following five major parameters were assessed: plantar fascia (n = 6), medial longitudinal arch (n = 9), hind- and midfoot joint pressures (n = 10), Achilles tendon (n = 5), and gait pattern parameters (n = 3). The quality of the studies was moderate to good with a pooled mean QUACS score of 65% (range 46-92%) for in-vitro and a pooled mean Coleman score of 58 (range 56-65) points for clinical studies.
CONCLUSIONS: A thorough knowledge of how MDCO impacts foot function is key in properly understanding the postoperative effects of this commonly performed procedure. According to the evidence, MDCO impacts the function of the plantar fascia and Achilles tendon, the integrity of the medial longitudinal arch, hind- and midfoot joint pressures, and consequently specific gait pattern parameters.
METHODS: A systematic literature search across two major sources (PubMed and Scopus) without time limitation was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria. Only original research studies reporting on biomechanical changes following a MDCO were included. Exclusion criteria consisted of review articles, case studies, and studies not written in English. 27 studies were included and the methodologic quality graded according to the QUACS scale and the modified Coleman score.
RESULTS: The 27 included studies consisted of 18 cadaveric, 7 studies based on biomechanical models, and 2 clinical studies. The impact of MDCO on the following five major parameters were assessed: plantar fascia (n = 6), medial longitudinal arch (n = 9), hind- and midfoot joint pressures (n = 10), Achilles tendon (n = 5), and gait pattern parameters (n = 3). The quality of the studies was moderate to good with a pooled mean QUACS score of 65% (range 46-92%) for in-vitro and a pooled mean Coleman score of 58 (range 56-65) points for clinical studies.
CONCLUSIONS: A thorough knowledge of how MDCO impacts foot function is key in properly understanding the postoperative effects of this commonly performed procedure. According to the evidence, MDCO impacts the function of the plantar fascia and Achilles tendon, the integrity of the medial longitudinal arch, hind- and midfoot joint pressures, and consequently specific gait pattern parameters.
摘要：
背景：进行性塌陷性足部畸形（PCFD），正式称为“成人获得性扁平足畸形”(AAFFD)，是一种复杂的足部畸形，由多个组成部分组成。如果需要手术,联合保存程序，如内侧移位跟骨截骨术（MDCO），经常执行。本系统综述的目的是总结MDCO对足部生物力学影响的证据。
方法：根据系统评价和荟萃分析（PRISMA）的首选报告项目，对两个主要来源（PubMed和Scopus）进行系统文献检索，没有时间限制。仅包括报告MDCO后生物力学变化的原始研究研究。排除标准包括评论文章，案例研究,学习不是用英语写的。纳入27项研究，根据QUACS量表和改良的Coleman评分对方法学质量进行分级。
结果：纳入的27项研究包括18具尸体，7项基于生物力学模型的研究，2项临床研究。评估了MDCO对以下五个主要参数的影响：足底筋膜（n=6），内侧纵弓（n=9），足后和中关节压力（n=10），跟腱(n=5),和步态模式参数(n=3)。研究的质量中等至良好，体外的合并平均QUACS评分为65％（范围46-92％），临床研究的合并平均Coleman评分为58分（范围56-65）。
结论：全面了解MDCO如何影响足部功能是正确理解这种常见手术的术后效果的关键。根据证据,MDCO影响足底筋膜和跟腱的功能，内侧纵弓的完整性，后足和中足关节压力，以及因此特定的步态模式参数。
方法：根据系统评价和荟萃分析（PRISMA）的首选报告项目，对两个主要来源（PubMed和Scopus）进行系统文献检索，没有时间限制。仅包括报告MDCO后生物力学变化的原始研究研究。排除标准包括评论文章，案例研究,学习不是用英语写的。纳入27项研究，根据QUACS量表和改良的Coleman评分对方法学质量进行分级。
结果：纳入的27项研究包括18具尸体，7项基于生物力学模型的研究，2项临床研究。评估了MDCO对以下五个主要参数的影响：足底筋膜（n=6），内侧纵弓（n=9），足后和中关节压力（n=10），跟腱(n=5),和步态模式参数(n=3)。研究的质量中等至良好，体外的合并平均QUACS评分为65％（范围46-92％），临床研究的合并平均Coleman评分为58分（范围56-65）。
结论：全面了解MDCO如何影响足部功能是正确理解这种常见手术的术后效果的关键。根据证据,MDCO影响足底筋膜和跟腱的功能，内侧纵弓的完整性，后足和中足关节压力，以及因此特定的步态模式参数。
