TY - JOUR
T1 - Treatment of chronic syndesmotic injury
T2 - A systematic review and meta-analysis
AU - Parlamas, George
AU - Hannon, Charles P.
AU - Murawski, Christopher D.
AU - Smyth, Niall A.
AU - Ma, Yan
AU - Kerkhoffs, Gino M.
AU - van Dijk, C. Niek
AU - Karlsson, Jon
AU - Kennedy, John G.
PY - 2013/8
Y1 - 2013/8
N2 - Purpose: The purpose of this study is to systematically review and meta-analyse the available literature on the treatment of chronic syndesmotic injuries of the ankle. Methods: A systematic review of the PubMed/MEDLINE and EMBASE databases was conducted in August 2012 utilizing the keywords (treatment OR intervention) AND (injury OR sprain OR rupture) AND (syndesmosis OR syndesmotic OR "high ankle" OR "anterior inferior tibiofibular ligament" OR AITFL OR "posterior inferior tibiofibular ligament" OR PITFL OR tibiofibular diastasis). Studies that reported the outcomes of the surgical treatment of chronic syndesmotic injury were included in our review. Chronic was defined as symptoms longer than 6 months. Meta-analysis based on random-effects models was performed to pool the rates of success for different treatment methods. Results: The search yielded 416 publications from PubMed/MEDLINE and 473 publications from EMBASE. After abstract and full-text review, 15 articles were included in this review. Treatment methods were placed into three broad surgical treatment categories: screw fixation, arthrodesis and arthroscopic debridement. The most common treatment strategy employed was screw fixation. The pooled rates of success for screw fixation, arthrodesis and arthroscopic debridement were 87.9, 79.4 and 78.7 %, respectively. Conclusion: The current evidence on the treatment of chronic syndesmosis injuries in the ankle is limited to prospective and retrospective case series. The pooled success rates for screw fixation, arthrodesis and arthroscopic debridement each exceeded 78 %. Future high-level studies are required to discern the most appropriate treatment strategy(ies) for chronic syndesmotic injuries of the ankle.
AB - Purpose: The purpose of this study is to systematically review and meta-analyse the available literature on the treatment of chronic syndesmotic injuries of the ankle. Methods: A systematic review of the PubMed/MEDLINE and EMBASE databases was conducted in August 2012 utilizing the keywords (treatment OR intervention) AND (injury OR sprain OR rupture) AND (syndesmosis OR syndesmotic OR "high ankle" OR "anterior inferior tibiofibular ligament" OR AITFL OR "posterior inferior tibiofibular ligament" OR PITFL OR tibiofibular diastasis). Studies that reported the outcomes of the surgical treatment of chronic syndesmotic injury were included in our review. Chronic was defined as symptoms longer than 6 months. Meta-analysis based on random-effects models was performed to pool the rates of success for different treatment methods. Results: The search yielded 416 publications from PubMed/MEDLINE and 473 publications from EMBASE. After abstract and full-text review, 15 articles were included in this review. Treatment methods were placed into three broad surgical treatment categories: screw fixation, arthrodesis and arthroscopic debridement. The most common treatment strategy employed was screw fixation. The pooled rates of success for screw fixation, arthrodesis and arthroscopic debridement were 87.9, 79.4 and 78.7 %, respectively. Conclusion: The current evidence on the treatment of chronic syndesmosis injuries in the ankle is limited to prospective and retrospective case series. The pooled success rates for screw fixation, arthrodesis and arthroscopic debridement each exceeded 78 %. Future high-level studies are required to discern the most appropriate treatment strategy(ies) for chronic syndesmotic injuries of the ankle.
KW - Ankle
KW - Chronic injury
KW - Syndesmosis
KW - Syndesmotic
UR - http://www.scopus.com/inward/record.url?scp=84880640865&partnerID=8YFLogxK
U2 - 10.1007/s00167-013-2515-y
DO - 10.1007/s00167-013-2515-y
M3 - Review article
C2 - 23620248
AN - SCOPUS:84880640865
VL - 21
SP - 1931
EP - 1939
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
SN - 0942-2056
IS - 8
ER -