A comparative study of modern total ankle replacement and ankle arthrodesis for ankle osteoarthritis at different follow-up times: a systematic review and meta-analysis

Liu, Shuai; Wang, Yuxin; Zhang, Mengqi; Wei, Pengcheng; Li, Yujing; Wang, Tongyu; Meng, Qiong

doi:10.1007/s00264-023-05753-6

Cited by 5 publications

(5 citation statements)

References 65 publications

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“…Our study suggests that the overall complication rate of TAR is not significantly different from that of AF. However, during subgroup analysis based on follow-up times, we observed a significantly lower complication rate for TAR at the 2-year mark compared to AF (RR = 0.53, CI: 0.35–0.79), which is in line with the results of short-term complication rates (complications occurring within 2 years) investigated by Liu et al, 21 which indicated an RR of 0.67. While some reports have indicated higher complication rates for TAR in long-term follow-up, 25,39,40 our study observed a higher complication rate for TAR compared to AF, although the difference was not statistically significant.…”

Section: Discussionsupporting

confidence: 90%

“…13 Numerous studies have sought to compare the outcomes of TAR and AF, but the findings have been quite diverse. [18][19][20][21]36,37 Prior research often combined prospective and retrospective studies for analysis, prompting us to exclusively include prospective studies for our meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18] However, some studies, such as those by Kim et al 19 and Shih et al, 20 have suggested higher complication rates associated with TAR. Liu et al 21 reported that TAR exhibited superior clinical scores and lower complications in short-term follow-ups but found no difference in clinical scores between the two methods in long-term follow-ups. Indeed, the inclusion of both prospective and retrospective studies may introduce selection bias, which could affect the comparative outcomes of TAR and ankle fusion.…”

Section: Introductionmentioning

confidence: 99%

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Total ankle replacement versus ankle fusion for end-stage ankle arthritis: A meta-analysis

Li,

Zhao,

Liu

et al. 2024

J Orthop Surg (Hong Kong)

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Purpose This study aims to systematically review the efficacy and safety of total ankle replacement (TAR) and ankle fusion (AF) as treatment options for end-stage ankle arthritis. Methods A comprehensive literature search was conducted on data from multiple databases, including PubMed, The Cochrane Library, Construction and Building Materials, Embase, Web of Science, and Scopus for RCTs and prospective cohort studies comparing TAR and AF in patients with end-stage ankle arthritis from inception up to June, 2023. Our primary outcomes of interest included patients’ clinical function scores and complications. We employed Review Manager 5.4 and Stata/MP 14.0 software for the meta-analysis. Results Our analysis incorporated 13 comparative studies, including 11 prospective studies, one pilot RCT, and one RCT. The pooled results revealed no significant difference in postoperative Short Form-36 scores between the TAR and AF groups (MD = −1.19, 95% CI: −3.89 to 1.50, p = .39). However, the postoperative Foot and Ankle Ability Measure scores in the AF group were significantly higher than in the TAR group (MD = 8.30, 95% CI: 1.01–15.60, p = .03). There was no significant difference in postoperative complication rates between the TAR and AF groups (RR = 0.95, 95% CI: 0.59 to 1.54, p = .85). Conclusion Currently available evidence suggests no significant disparity in postoperative outcomes between TAR and AF. In the short term, TAR demonstrates better clinical scores than AF and lower complication rates. Conversely, in the long term, AF exhibits superior clinical scores and lower complication rates, although this difference is not statistically significant.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Total ankle replacement versus ankle fusion for end-stage ankle arthritis: A meta-analysis

Li,

Zhao,

Liu

et al. 2024

J Orthop Surg (Hong Kong)

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“…A review team from Qingdao (China) undertook a systematic review and meta-analysis in an attempt to establish the efficacy of AA versus TAA over the short, medium, and long term. 5 The inclusive initial search identified 2,750 relevant articles, of which 37 were ultimately included for meta-analysis. A majority were retrospective (n = 23) and the rest prospective.…”

Section: Ankle Arthroplasty Versus Arthrodesis: Which Comes Out On Top?mentioning

confidence: 99%

Foot & Ankle

2023

Bone &Amp; Joint 360

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The December 2023 Foot & Ankle Roundup360 looks at: Subchondral bone cysts remodel after correction of varus deformity in ankle arthritis; 3D-printed modular endoprosthesis reconstruction following total calcanectomy; Percutaneous partial bone excision in the management of diabetic toe osteomyelitis; Hemiepiphysiodesis is a viable surgical option for Juvenile hallux valgus; Ankle arthroplasty vs arthrodesis: which comes out on top?; Patient-related risk factors for poorer outcome following total ankle arthroplasty; The Outcomes in Ankle Replacement Study.

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“…In another systematic review and meta-analysis, 37 comparative studies were included. [ 9 ] The TAA had advantages over AF in the short term due to better performance in terms of patient-reported outcome measures (PROMs), complications, and reoperation rates, but its complications become a disadvantage in the medium term. In the long term, AF seems to be favored due to lower complications and revision rates, although there is no difference in clinical scores.…”

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confidence: 99%