Reviving the debate: Articular cartilage preservation during disarticulation at the lower limb? A systematic review
•There is a lack of consensus considering the removal and preservation of articular cartilage during disarticulations.•Preservation of the articular cartilage has no adverse effect on achieving wound healing, functionality and mortality.•There is an uncertain link with the status of the cartilage an...
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| Published in: | Foot and ankle surgery Vol. 27; no. 3; pp. 246 - 251 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
France
Elsevier Ltd
01-04-2021
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | •There is a lack of consensus considering the removal and preservation of articular cartilage during disarticulations.•Preservation of the articular cartilage has no adverse effect on achieving wound healing, functionality and mortality.•There is an uncertain link with the status of the cartilage and infection risk.•There is a possible association between the removal of articular cartilage and reamputation rate in the lower limb.
The need for preservation(P) or removal(R) of articular cartilage during disarticulations remains unanswered.
Medline database was used to conduct a systematic review regarding all types of minor disarticulations and some types of major disarticulations in patients with diabetes mellitus, peripheral arterial disease or trauma related disarticulations. Fisher-exact statistical test was used to perform calculations for the entire group as for subgroups.
A total of 444 disarticulations at the Chopart joint, ankle and knee were included (P = 255 vs. R = 189). There was no difference in wound healing, functionality and mortality. Reamputation rate was lower in the P-group (9.4% vs. 16.9%). Infection rate was not significantly different. Differences in reamputations (R = 10.6% vs. P = 1.0%) and infections (R = 4.4% vs. P = 22.6%) were only present for the ankle subgroup.
There is no difference in wound healing, functionality and mortality between the preservation and removal of articular cartilage in the lower limb. |
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| Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
| ISSN: | 1268-7731 1460-9584 |
| DOI: | 10.1016/j.fas.2020.12.010 |