摘要
据统计踝关节炎患者约占全世界成年人口的1%,是严重的全球疾病负担。然而与髋、膝关节炎相比,临床对于踝关节炎的认识及治疗仍处于起步阶段。对于终末期踝关节炎,既往认为踝关节融合术是治疗“金标准”,但融合术后患者关节活动度丧失,步态改变、日常活动受限、邻近关节加速退变。因此,如何在缓解疼痛的同时保留踝关节活动度是治疗关键。目前,踝关节炎手术方式主要包括关节镜下关节清理术、关节周围截骨术、骨软骨移植术、踝关节牵张成形术,以及踝关节融合术、全踝关节置换术等。术者应基于患者症状、体征、影像学表现、需求、经济情况等因素综合考虑,选择个性化治疗方案。但目前尚无相关指南给出明确治疗建议,因此有必要对踝关节炎的诊治进行广泛而深入的探讨。
Ankle arthritis affects approximately 1%of the adult population worldwide and represents a serious global disease burden.However,compared with hip arthritis and knee arthritis,the clinical understanding and treatment of ankle arthritis are still in their infancy.For end-stage ankle arthritis,ankle arthrodesis was considered as the“gold standard”in the past.However,ankle arthrodesis will result in loss of joint mobility,altered gait,limited daily activities,and accelerated degeneration of adjacent joints.Therefore,how to preserve the range of motion of the ankle joint while relieving pain is the key to the treatment of ankle arthritis.Currently,the surgical treatment of ankle arthritis includes arthroscopic debridement,periarticular osteotomies,osteochondral transplantation,ankle distraction arthroplasty,ankle arthrodesis,and total ankle arthroplasty.The choice of treatment should be individualized and based on various factors such as the patient's symptoms,signs,imaging performance,complaints,and financial situation.However,there are no guidelines that give clear treatment recommendations.Therefore,it is necessary to conduct extensive and in-depth discussions on the diagnosis and treatment of ankle arthritis.
作者
李亚星
张晖
LI Yaxing;ZHANG Hui(Department of Orthopedics,Orthopedic Research Institute,West China Hospital,Sichuan University,Chengdu Sichuan,610041,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2023年第7期769-775,共7页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
踝关节炎
保踝手术
踝关节置换术
Ankle arthritis
ankle preservation
total ankle arthroplasty
