硬腰是最常见的足部关节炎,由于多种因素。关节固定术和介入关节成形术是在疾病晚期考虑的治疗方法。当保守治疗失败时。尽管关节固定术可能被认为是多个作者推荐的技术,对于要保留关节活动度的患者,关节成形术可能是一种可靠的替代方法。这项系统评价的目的是研究和比较中度和重度hallux硬体的关节固定术和介入式关节成形术的临床结果和并发症。
方法:在这篇系统综述中,我们搜索了COCHRANE,EMBASE,PUBMED数据库。获得了26篇研究论文,总共有1348英尺,包括在内进行定性分析。包括以下组:Cartiva半髋关节置换术(286),双杆硅胶关节成形术(276),全金属关节成形术(394)和关节固定术(392)。
结果:在关节固定术组中,AOFAS-HMI评分是最常用的,术前范围为36至45,术后范围为79至89。VASPAIN评分的最年夜改良为从86到4。融合率为总例数的98.6%,最常见的并发症是物质不适引起的疼痛.在全金属关节成形术组中,ROTO-GLIDE系统报告AOFAS得分为95分,并发症发生率低;但是,使用TOEFIT-PLUS和BIOMED-MERCK系统,尽管术后价值很好,在随访时间最长的系列中,他们报告由于无菌性松动而进行了37%和15%的翻修,分别。Cartiva组的FAAMADL和FAAMSPORT分别从59.4到90.4和从60.9到89.7显着增加;类似地,据报道,移除植入物和转化为关节固定术占20.5%。最后,双茎硅胶关节成形术组,在随访时间最长的系列中,它设法将MOXFQ分数从78.1提高到11.0,平均移动范围为22.3度。10%的病例报告了溶解。
结论:关节融合术已被证明是治疗晚期hallux硬体的最佳选择。对于需要保持关节活动范围的患者,关节成形术是一种有效的选择;然而,重要的是要告知短期和中期可能出现的并发症。
方法:II.
Hallux rigidus is the most frequent arthritis of the foot, due to multiple factors. Arthrodesis and interposition arthroplasty are treatments considered in advanced stages of the disease, when conservative treatment has failed. Although arthrodesis may be considered the technique recommended by multiple authors, for patients in whom joint mobility is to be preserved, arthroplasty could represent a reliable alternative. The purpose of this systematic
review is to investigate and compare the clinical outcomes and complications of arthrodesis and interposition arthroplasty for moderate and severe stages of hallux rigidus.
METHODS: For this systematic
review we searched COCHRANE, EMBASE, PUBMED databases. Twenty-six research papers were obtained, with a total of 1348 feet, which were included for qualitative analysis. The following groups were included: Cartiva hemiarthroplasty (286), double stem silicone arthroplasty (276), total metallic arthroplasty (394) and arthrodesis (392).
RESULTS: In the arthrodesis group, the AOFAS-HMI score was the most used, ranging from 36 to 45 in the preoperative period and from 79 to 89 in the postoperative period. The greatest improvement in the VAS PAIN score was from 86 to 4. The fusion rate was 98.6% of the total number of cases, the most frequent complication was pain due to material discomfort. In the total metallic arthroplasty group, the ROTO-GLIDE system reported an AOFAS score of 95 points, with low complication rates; but, with the TOEFIT-PLUS and BIOMED-MERCK systems, despite the good postoperative value, they report 37% and 15% revision due to aseptic loosening in the series with the longest follow-up, respectively. The Cartiva group showed a significative increase in FAAM ADL and FAAM SPORT from 59.4 to 90.4 and from 60.9 to 89.7, respectively; similarly, 20.5% implant removal and conversion to arthrodesis were reported. Finally, the double stem silicone arthroplasty group, in the series with the longest follow-up, it manages to improve the MOXFQ score from 78.1 to 11.0, with an average range of mobility of 22.3 degrees. Lysis was reported in 10% of cases.
CONCLUSIONS: Arthrodesis has proven to be the best option for the treatment of advanced hallux rigidus. Arthroplasty can be a valid option for patients who demand to maintain the range of mobility of the joint; however, it is important to inform about the complications that may arise in the short and medium term.
METHODS: II.