Table 1.
Features and results of the selected papers about arthroscopic debridement, arthrodiastasis and osteotomy in AOA
Authors | Year of publication | Type of study | Number of patients | Inclusion criteria | Treatment | Follow-up (months) | Clinical results | Radiological results | Notes |
---|---|---|---|---|---|---|---|---|---|
Arthroscopic debridement | |||||||||
Tol et al | 2001 | Prospective case series | 57 | Anterio bony impingement and moderate AOA | Arthroscopic debridement | 78 | Excellent or good (VAS and Tegner) | 65 % successful | AOA reduces the success rate |
Parma et al | 2014 | Retrospective case series | 80 | Anterio bony impingement and moderate AOA | Arthroscopic debridement | 105 | Aofas score 70.7 pt at final follow-up | NA | Chondral lesions, age and cavus foot negatively affect the outcome |
Choi et al | 2013 | Retrospective case series | 63 | Mild and moderate AOA | Arthroscopic debridement | 71 | Aofas score 76.2 pt at final follow-up | NA | High BMI and chondral lesions reduce the success rate |
Hassouna et al | 2007 | Prospective case series | 80 | Anterio bony impingement and moderate AOA | Arthroscopic debridement | 60 | 28 % requiring major surgery at 5 years | NA | AOA reduces the success rate |
Arthrodiastasis | |||||||||
Ploegmaker et al | 2005 | Retrospective case series | 25 | Severe AOA | Fixed joint distraction | 84 | 73 % clinical benefit at 7 years | NA | Distraction has long term benefit |
Marijnissen et al | 2002 | Open prospective study | 57 | Severe AOA | Fixed joint distraction | 34 | Good pain control, more mobility | Joint space width increased 10 % | Improvement increased over the time |
Marijnissen et al | 2002 | Randomized controlled trial | 17 | Severe AOA | Joint distraction vs debridement | 12 | Good pain control, more mobility | Less subchondral sclerosis, more joint space | Better clinical and radiological results for arthrodiastasis |
Tellisi et al | 2009 | Retrospective case series | 25 | Severe AOA | Joint distraction | 30 | Aofas score at the final follow-up: 74 | NA | 91 % improved pain |
Nguyen et al | 2015 | Retrospective case series | 36 | Severe AOA | Fixed joint distraction | 60 | 45 % requiring arthrodesis or replacement | Progression of AOA | Outcome decreased over the time |
Marijnissen et al | 2014 | Retrospective case series | 111 | Severe AOA | Fixed or hinged joint distraction | 144 | 50 % of failures | NA | Outcome decreased over the time |
Osteotomy | |||||||||
Knupp et al | 2011 | Prospective case series | 94 | Asimmetric AOA | Supramalleolar osteotomy | 43 | Good clinical improvement | AOA improved | 10 patients failed |
Colin et al | 2014 | Retrospective case series | 83 | Asimmetric AOA | Supramalleolar osteotomy | 42 | Aofas score 73 pt for varus and 80 for valgus | Improved | Sidewalk sign to assess the correct indication |
Kim et al | 2014 | Retrospective case series | 31 | Asimmetric (varus) AOA | Supramalleolar osteotomy and microfractures | 27 | Aofas score 83.1 pt at final follow-up | 42 % AOA advancement | Microfractures may improve the results |