A Survey for End-Stage Ankle Arthritis Treatment: Ankle Arthrodesis Versus Ankle Arthroplasty
A Survey for End-Stage Ankle Arthritis Treatment: Ankle Arthrodesis Versus Ankle Arthroplasty
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DOI：
10.1053/j.jfas.2019.09.007
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发表时间：
2020-03-01
影响因子：
1.3
通讯作者：
Petrisor, Bradley A.
中科院分区：
文献类型：
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作者：
Tai, Kerry;Vannabouathong, Christopher;Petrisor, Bradley A.
随着技术的进步，踝关节置换术已成为治疗终末期踝关节炎的传统金标准关节固定术的替代方案。我们通过对 103 名骨科医生进行横断面调查，收集了有关这两种手术的知识和看法，以确定这些患者是否需要患者决策辅助。受访者主要为男性，年龄在 41 至 50 岁之间。一半表示自己不进行关节置换术的人表示，这是因为他们没有接受过足够的培训。此外，某些变量与外科医生选择的干预措施相关：患者性别、年龄、体重指数、术后活动水平、就业类型、感知的感染风险、神经血管损伤或伤口并发症、发生或预先存在邻近关节炎的风险、畸形、排列不齐、骨质流失或骨质量异常、既往踝关节手术次数、关节炎原因以及保留运动的愿望。大多数人同意他们总是将患者的偏好纳入他们的决策中，并且决策辅助将是有益的。这项调查显示，一些患者特征会影响外科医生对终末期踝关节炎进行关节置换术或关节融合术的偏好。由于大多数外科医生在他们的决策中考虑了患者的偏好，并报告说决策辅助将有助于在这种临床情况下做出明智的决策，因此这项调查发现了支持为这些患者开发此类工具的未满足的需求。 (C) 2019 年，美国足踝外科医生学会。版权所有。
With promising technological advances, ankle arthroplasty has become an alternative to arthrodesis, traditionally the gold standard, for treating end-stage ankle arthritis. We collected knowledge and perceptions on both procedures to determine the need for a patient decision aid for these patients by administering a cross-sectional survey to 103 orthopaedic surgeons. Respondents were predominantly male and 41 to 50 years old. Half of those who stated that they do not perform arthroplasty said this was because they do not have adequate training. Additionally, certain variables were associated with the surgeon's choice of intervention: patient gender, age, body mass index, postoperative activity level, employment type, perceived risk of infection, neurovascular injury or wound complication, risk of developing or pre-existing adjacent arthritis, deformity, malalignment, bone loss or abnormal bone quality, number of prior ankle operations, cause of arthritis, and desire for motion preservation. The majority agreed that they always incorporate patient preferences into their decisions and that a decision aid would be beneficial. This survey revealed that several patient characteristics are influential in the surgeon's preference for either arthroplasty or arthrodesis for end-stage ankle arthritis. Because the majority of surgeons incorporate patient preferences in their decisions and report that a decision aid would be beneficial for informed decision-making in this clinical scenario, this survey identified an unmet need supporting the development of such a tool for these patients. (C) 2019 by the American College of Foot and Ankle Surgeons. All rights reserved.