Meta-Analysis: Comparison Of Ankle Arthroplasty And Arthrodesis In Rheumatoid Arthritis Patients

초록

Objectives: The objective of this meta-analysis is to compare the clinical outcomes of ankle arthroplasty and arthrodesis in rheumatoid arthritis patients, focusing on pain relief, functional improvement, complication rates, and reoperation rates. Methods: A systematic review was conducted based on PRISMA guidelines, including six studies with a total of 216 patients (112 treated with arthroplasty and 104 with arthrodesis). Relevant studies were identified through a comprehensive search of PubMed, Embase, and Cochrane Library databases. Data on pain scores, functional outcomes, complication rates, and reoperation rates were extracted and analyzed using a random-effects model. Heterogeneity among studies was evaluated using the I2 statistic, and statistical significance was set at p < 0.05. Results: Both ankle arthroplasty and arthrodesis significantly reduced postoperative pain in rheumatoid arthritis patients. Ankle arthroplasty demonstrated greater pain relief, with a mean improvement of 1.5 points on the visual analog scale (VAS) compared to arthrodesis. Functional improvement, as measured by standardized scoring systems such as AOFAS scores, was also higher in the arthroplasty group, with an average improvement of 10 points. However, arthroplasty was associated with higher complication rates, including implant loosening and infection, compared to arthrodesis. Reoperation rates were also higher in the arthroplasty group (25%) compared to the arthrodesis group (12%). Conclusions: In rheumatoid arthritis patients, ankle arthroplasty provides superior pain relief and functional improvement compared to arthrodesis. However, it carries a higher risk of complications and reoperations. These findings highlight the importance of individualized treatment planning and shared decision-making when selecting surgical interventions for ankle involvement in rheumatoid arthritis. Further randomized controlled trials are needed to confirm these findings.