背景:所有骨科手术,包括脚和脚踝手术,似乎显示出积极的趋势,最近。骨移植物通常用于修复外伤引起的骨异常,疾病,或其他医疗条件。这项研究特别着重于回顾各种骨替代品的安全性和有效性,专门用于足部和踝关节手术,将它们与自体骨移植进行比较。
方法:系统搜索涉及扫描电子数据库,包括PubMed,Scopus,Cochrane在线图书馆,和WebofScience,采用像“骨替代品”这样的术语,合成骨移植,\'\'自体移植,\'和\'踝关节。纳入标准包括RCT,病例对照研究,和前瞻性/回顾性队列探索足部和踝关节手术中不同的骨替代物。使用R软件进行Meta分析,整合优势比和95%置信区间(CI)。Cochrane的Q检验评估了异质性。
结果:本系统综述分析了8篇文献,共894例患者。在这些中,497名患者接受了合成骨移植,397例患者接受自体骨移植。在五项研究中进行了关节固定术,和三项研究使用开放还原技术。在合成骨移植物中,三项研究使用了重组人血小板衍生生长因子BB同二聚体(rhPDGF-BB)和β-磷酸三钙(β-TCP)胶原蛋白的组合,而四项研究使用羟基磷灰石化合物。一项研究没有提供这方面的细节。荟萃分析显示,在并发症的发生方面有类似的发现,以及在放射学和临床评估中,将自体移植物与合成骨移植物进行对比。
结论:合成骨移植有望在放射学方面获得可比的结果,临床,和生活质量方面,并发症较少。然而,额外的研究是必要的,以确定其使用的最佳方案,并彻底确认其有效性。
方法:二级。
BACKGROUND: All orthopaedic procedures, comprising foot and ankle surgeries, seemed to show a positive trend, recently. Bone grafts are commonly employed to fix bone abnormalities resulting from trauma, disease, or other medical conditions. This study specifically focuses on reviewing the safety and efficacy of various bone substitutes used exclusively in foot and ankle surgeries, comparing them to autologous bone grafts.
METHODS: The systematic search involved scanning electronic databases including PubMed, Scopus, Cochrane online library, and Web of Science, employing terms like \'Bone substitute,\' \'synthetic bone graft,\' \'Autograft,\' and \'Ankle joint.\' Inclusion criteria encompassed RCTs, case-control studies, and prospective/retrospective cohorts exploring different bone substitutes in foot and ankle surgeries. Meta-analysis was performed using R software, integrating odds ratios and 95% confidence intervals (CI). Cochrane\'s Q test assessed heterogeneity.
RESULTS: This systematic review analyzed 8 articles involving a total of 894 patients. Out of these, 497 patients received synthetic bone grafts, while 397 patients received autologous bone grafts. Arthrodesis surgery was performed in five studies, and three studies used open reduction techniques. Among the synthetic bone grafts, three studies utilized a combination of recombinant human platelet-derived growth factor BB homodimer (rhPDGF-BB) and beta-tricalcium phosphate (β-TCP) collagen, while four studies used hydroxyapatite compounds. One study did not provide details in this regard. The meta-analysis revealed similar findings in the occurrence of complications, as well as in both radiological and clinical evaluations, when contrasting autografts with synthetic bone grafts.
CONCLUSIONS: Synthetic bone grafts show promise in achieving comparable outcomes in radiological, clinical, and quality-of-life aspects with fewer complications. However, additional research is necessary to identify the best scenarios for their use and to thoroughly confirm their effectiveness.
METHODS: Level II.