Fair evidence consistently supports open surgical treatment for chronic ankle instability: a systematic review
Notice bibliographique
Résumé
What is already known► Open procedures have been the mainstay of surgical treatment of chronic ankle instability for many decades.► Reports of novel minimally invasive and arthroscopic techniques have increased in recent years.► A recent systematic review identified only poor-quality evidence in support of minimally invasive surgical approaches to chronic ankle instability.What are the new findings ► The results of this study demonstrate the paucity of high-quality evidence in support of open operative procedures for the treatment of chronic ankle instability (CAI).► This systematic review helps reassure clinicians of their current practice, but emphasises the need for future high-quality evidence to support the use of open operative techniques for CAI.AbSTrACT Importance Patients with chronic ankle instability (CAI) who have failed non-operative treatments are most commonly treated with open ankle repair or reconstruction of the anterior talofibular ligament and/or calcaneofibular ligament.Over 50 operative techniques have been described for the treatment of CAI.However, there is no current systematic evaluation of currently used open operative techniques for the treatment of CAI.Aim/Objective The primary objective of this study is to provide evidence-based treatment recommendations for CAI in adults based on a comprehensive systematic review of the literature.Evidence review The literature review of PubMed, EMBASE, Cochrane and Web of Science databases was completed on 22 February 2017.Search terms included two concepts: lateral ligament of the ankle (patients) and open reconstructive or repair procedures (intervention).All published clinical studies with English translation were included.Biomechanical, cadaveric, review articles, minimally invasive procedures and arthroscopic procedures were excluded.Open operative procedures from included articles were classified as anatomical or non-anatomical and repair or reconstructive.Articles were then assigned a level of evidence (I-V) to denote quality of the research methods.Articles were reviewed collectively to provide a grade of recommendation (A-C or I) in support for or against the operative intervention in treatment of CAI.Findings Seventy one of 1635 identified articles were included for review.There is fair evidence (Grade B) in support of anatomical repair, anatomical reconstruction and non-anatomical reconstruction procedures.There was insufficient evidence available to grade internal brace and non-anatomical repair procedures.Conclusions and relevance Although only fair-quality evidence exists in support of open operative treatment of CAI, this systematic review helps reassure clinicians of their current practices.The literature reaffirms support for open anatomical repair and anatomical reconstruction technique for CAI.Level of evidence Level II, systematic review.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,065 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,009 | 0,008 |
| Bibliométrie | 0,007 | 0,008 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».