Contoh sysrev total ankle athroplasty.pptx

Publication about systematic review, topic about total ankle arhtroplasty

1. Effects Of Ankle Arthroplasty On Motor Function Recovery In Patients With Orthopedic Ankle Injury A Systematic Review And Meta-Analysis Roberto Alexi 1 , Sebastian Chendra 2 , Hendsun Hendsun 3 1 General Practitioner, Saint Vincentius Hospital, Singkawang 2 General Practicioner , Faculty Of Medicine, Tarumanagara University 3 Master of Hospital Administration, Universitas Pelita Harapan, Jakarta

2. ABSTRACT Introduction : Ankle injuries are a common problem that affects people of all ages and activity levels. The treatment for ankle injuries depends on the severity of the injury. More severe injuries may require surgery included ankle arthroplasty and physical therapy. The procedure is typically performed in patients with severe ankle arthritis or other conditions that have caused significant damage to the ankle joint. Methods: This study was traced from Google Scholar, Pubmed , Science Direct, and Elsevier Clinicalkey digital search pages systematically. This study included a randomize controlled trial that assessed patients who undergoes with ankle replacement compared with those who did not performed with ankle replacement. Quality assessment was carried out using Cochrane's Review Manager 5.4 application. Results: A total of 4 articles, including 443 patients, were analyzed. The meta-analysis showed significant improvement in AOFAS scores among patients in the experiment group (who underwent ankle replacement) compared with those in the control group (who did not undergo ankle replacement) [mean difference (MD) =−44.42, 95% confidence interval (CI): −47.02 to 41.82, Z=33.50, P<0.00001), VAS scores (MD =5.49, 95% CI: 5.01 to 5.96, Z=22.63, P<0.00001), FAAM scores (MD =−25.78, 95% CI: −31.27 to 20.29, Z=9.20, P<0.00001) compared to patients in the control group. Discussion: The quality of life, daily activities, and motor function recovery of patients with orthopedic ankle injuries were all improved with ankle arthroplasty. Conclusions: A nkle arthroplasty improves motor function, quality of life, and daily activities in patients with orthopedic ankle injuries. To validate the clinical application of ankle arthroplasty, future studies involving higher-quality research, larger sample sizes, and more outcome indicators are required. Keywords: Ankle arthroplasty, Ankle prosthesis, Motor function

3. Background 01.

4. Ankle Injuries A common problem that affects people of all ages and activity levels. C aused by a variety of factors, including sports, physical activity, and accidents Most common injuries : ankle sprains, ankle strains, ankle fractures, and ankle dislocations. Any ankle injury has a chance of developing ankle arthtritis later can have a major impact on individual’s daily lives. INTRODUCTION

5. Ankle Arthroplasty A surgical procedure that involves replacing a damaged or worn-out ankle joint with a prosthesis T ypically performed in patients with severe ankle arthritis or other conditions that have caused significant damage to the ankle joint Types : total (TAR) / partial (PAR) Primary goal : alleviate pain and improve mobility in the affected joint. ankle arthroplasty requires careful patient selection and preparation, skilled surgical technique and appropriate postoperative care Complications : infection, implant failure, nerve damage, delayed healing, allergic reaction, pain and stiffness, compartment syndrome, fractures, loosening of the implant INTRODUCTION

6. Aim of the study To compare motor function between ankle arthoplasty and non-surgical intervention in patients with ankle injuries who developed ankle arthtritis . Motor function and pain were analyzed by three parameters: AOFAS, FAAM, VAS score. INTRODUCTION

7. Study design 01. Systematic review and meta-analysis Databases 02. Google Scholar, Pubmed , Science Direct, and Elsevier Clinicalkey Inclusion criteria 03. RCTs that assessed patients who undergoes with ankle replacement compared with those who did not performed with ankle replacement. Programme 04. Cochrane's Review Manager 5.4 STUDY METHODS

8. Outcomes 05. Systematic review and meta-analysis STUDY METHODS AOFAS score American Orthopaedic Foot and Ankle Society Ankle and Hindfoot score The most commonly used instruments for measuring the outcome of treatment in patients who sustained a complex ankle or hindfoot injury.  FAAM score VAS score Foot and Ankle Ability Measures To evaluate the functional limitations of individuals with ankle injuries based on activities of daily living + sports performance Visual Analog Scale To measure pain intensity based on patient’s perspecitves

9. RESULTS First Author (Years) Randomization Allocation Concealment Withdrawals and dropouts Reason for dropouts and withdrawals Outcome Indicators Test Control Braito M (2014) Yes NMT MT No AOFAS, VAS 101 40 Dalat F (2014) Yes NMT MT Yes AOFAS, SF-36, FAAM 59 46 Brunner S (2013) Yes NMT MT Yes AOFAS, VAS 72 72 Pedowitz DI (2016) Yes NMT MT No VAS, FAAM 41 27 Number of studies included : 4 studies (443 patients)

10. AOFAS score The meta-analysis showed significant improvement among patients in the experiment group (MD−44.42, 95% CI −47.02 to 41.82, Z=33.50, P<0.00001) RESULTS

11. VAS score The meta-analysis showed significant improvement among patients in the experiment group (MD =5.49, 95% CI: 5.01 to 5.96, Z=22.63, P<0.00001) RESULTS

12. VAS score The meta-analysis showed significant improvement among patients in the experiment group (MD =−25.78, 95% CI: −31.27 to 20.29, Z=9.20, P<0.00001) RESULTS

13. DISCUSSION Main findings Comparison to previous studies The quality of life, daily activities, and motor function recovery of patients with orthopedic ankle injuries were all improved with ankle arthroplasty. Tang et al (2022): Ankle arthroplasty had a positive effect on the quality of life, daily activities, and motor function recovery of patients with orthopedic ankle injuries

14. DISCUSSION Parameters Current study Tang et al (2022) AOFAS MD = −44.42, 95% CI: −47.02 to 41.82, Z=33.50, P<0.00001 MD = −41.89, 95% CI : −51.29 to 32.49, Z=8.73, P<0.00001 FAAM MD =−25.78, 95% CI: −31.27 to 20.29, Z=9.20, P<0.00001 MD =−25.78, 95% CI: −31.27 to 20.29, Z=9.20, P<0.00001 VAS MD = 5.49, 95% CI: 5.01 to 5.96, Z=22.63, P<0.00001 MD =5.59, 95% CI: 4.84 to 6.34, Z=14.56, P<0.00001 SF-36 Not assessed MD =−13.89, 95% CI: −26.74 to 1.04, Z=2.12, P=0.03 Both shows similar results

15. DISCUSSION Ankle arthroplasty Main purpose : to provide patients with a more stable and functional ankle joint. The replaced ankle prostheses generally require good soft tissue tension and non-collision ROM This joint replacement can effectively improve the symptoms of joint pain in patients Clinical implication of study results : Ankle arthroplasty can be done to improve motor function, quality of life, and daily activities in patients with orthopedic ankle injuries Limitations of this study : Limited number of studies included Risk of bias of each study was not assessed Specific analyses for each ankle injuries were not able to be done

16. What this study adds What needs to be explained further Which injuries / patients will benefit most from TAA? What are the complicatons of TAA ? How often does it happen ? This study provides more evidence that TAA yield satisfactory results

17. Conclusion Ankle arthroplasty improves motor function, quality of life, and daily activities in patients with orthopedic ankle injuries. To validate the clinical application of ankle arthroplasty, future studies involving higher-quality research, larger sample sizes, and more outcome indicators are required.

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