Introduction
Material and methods
Search strategy
Eligibility criteria
Study selection
Data extraction
Quality assessment
Best-evidence synthesis
Statistical analysis
Results
Search and literature selection
Quality assessment
PRJ | C | R | MA | G | CC | COI | I/E | F/U | Stats | Total | |
---|---|---|---|---|---|---|---|---|---|---|---|
Adachi et al. [2] | + | + | + | + | 4 | ||||||
Cho et al. [5] | + | + | + | + | + | + | 6 | ||||
Hui et al. [10] | + | + | + | 3 | |||||||
Karlsson et al. [12] | + | + | + | 3 | |||||||
Kollias et al. [13] | + | + | + | 3 | |||||||
Maffulli et al. [18] | + | + | + | + | + | 5 | |||||
Ogawa et al. [25] | + | + | + | + | + | 5 | |||||
Porter et al. [27] | + | + | + | + | 4 | ||||||
Raikin et al. [29] | + | + | + | + | + | 4 | |||||
Saxena et al. [33] | + | + | + | + | 5 | ||||||
Tomihara et al. [39] | + | + | + | + | 4 | ||||||
Walther et al. [41] | + | + | + | 3 | |||||||
Wang et al. [42] | + | + | + | + | + | 5 | |||||
Zhenbo et al. [43] | + | + | + | + | + | 5 | |||||
Total | 14 | 11 | 2 | 8 | 1 | 14 | 9 | 59 | |||
Average | 4.2 |
Outcomes | Outcome measure | High-quality studies | Low-quality studies | BES |
---|---|---|---|---|
Group A: SPR repair | RTS rate | Moderate | ||
AOFAS improvement | Moderate | |||
Satisfaction | Moderate | |||
Group B: Groove deepening and SPR repair | RTS rate | Moderate | ||
AOFAS improvement | Moderate | |||
Satisfaction | Limited | |||
Group C: Bony procedure | RTS rate | Limited | ||
AOFAS improvement | Limited | |||
Satisfaction | [43] | Limited | ||
Group D: Rerouting procedure | RTS rate | [42] | Limited | |
AOFAS improvement | [42] | Limited | ||
Satisfaction | [42] | Limited |
Evaluation of study characteristics
Study | Study design | Group | Patient demographics | Concomitant ankle comorbidities | Follow-up |
---|---|---|---|---|---|
Adachi et al. [2] | Retrospective case series | A |
N = 20, age = 24 year gender M/F = 17/3 | Lateral ankle instability (N = 2) | Mean = 38 months (24–86 months) |
Cho et al. [5] | Prospective, comparative case series | A |
N = 16 (29), age = 21 year gender M/F = 16/0 |
N = 0 | Mean = 33 months (22–45 months) |
Cho et al. [5] | Prospective, comparative case series | B |
N = 13 (29), age = 20 year gender M/F = 13/0 |
N = 0 | Mean = 25 months (17–38 months) |
Hui et al. [10] | Retrospective case series | A |
N = 21, age = 24 year gender M/F = 18/3 | Not reported | Mean = 112 months (42–180 months) |
Karlsson et al. [12] | Retrospective case series | B |
N = 15, age = 23 year gender M/F = 10/5 | Not reported | Mean = 42 months (24–84 months) |
Kollias et al. [13] | Retrospective case series | B |
N = 11, age = 25 year gender M/F = unknown | Intra articular changes (N = 10), lateral ankle instability (N = 3) | Mean = 72 months (24–102 months) |
Maffulli et al. [18] | Retrospective case series | A |
N = 14, age = 25 year gender M/F = 14/0 | Not reported | Mean = 38 months (22–47 months) |
Ogawa et al. [25] | Retrospective case series | B |
N = 15, age = 33 year gender M/F = 8/7 |
N = 0 | Mean = 13 months (3–36 months) |
Porter et al. [27] | Case series | B |
N = 13, age = 24 year gender M/F = 9/4 |
N = 0 | >12 months |
Raikin et al. [29] | Retrospective case series | B |
N = 14, age = 34 year gender M/F = 14/0 | Peroneal brevis rupture (N = 5) Peroneal longus rupture (N = 1) | Mean = 32 months (26–45 months) |
Saxena et al. [33] | Prospective cohort study | B |
N = 31, age = 33 year gender M/F = unknown | Peroneal brevis rupture (N = 9) Ankle instability (N = 6) | >2 years |
Tomihara et al. [39] | Retrospective, comparative case series | A |
N = 19 (15 athletes), age = 23 year gender M/F = 15/4 | Not reported | Mean = 51 months (18–120 months) |
Tomihara et al. [39] | Retrospective, comparative case series | C |
N = 15 (11 athletes), age = 17 year gender M/F = 10/5 | Not reported | Mean = 66 months (18–210 months) |
Walther et al. [41] | Case series | B |
N = 23, age = 34 year gender M/F = unknown |
N = 0 | 24 months |
Wang et al. [42] | Retrospective case series | D |
N = 17, age = 23 year gender M/F = 17/0 |
N = 0 | Mean = 28 months (24–60 months) |
Zhenbo et al. [43] | Retrospective, comparative case series | C |
N = 26, age = 29 year gender M/F = 18/8 |
N = 0 | Mean = 57 months (36–96 months) |
Study | Groupa
| Return to sports | AOFAS | Satisfactionb
| Redislocation |
---|---|---|---|---|---|
Adachi et al. [2] | A | 83 % | Pre m = 76, post m = 93 |
N = 0 | |
Cho et al. [5] | A | 100 %, mean 3.0 months | Pre m = 60, post m = 93 |
E = 4, G = 10, p = 2 |
N = 1 |
Cho et al. [5] | B | 100 %, mean 3.1 months | Pre m = 59, post m = 91 |
E = 3, G = 9, p = 1 |
N = 0 |
Hui et al. [10] | A | 86 |
N = 0 | ||
Karlsson et al. [12] | B | 100 %, mean 4.5 months |
N = 0 | ||
Kollias et al. [13] | B | 91 %, mean 9.1 month | Pre m 53, post m 96 |
N = 0 | |
Maffulli et al. [18] | A | Pre m = 5, post m = 95 |
E = 12, G = 2 |
N = 0 | |
Ogawa et al. [25] | B | Post m = 87 |
N = 0 | ||
Porter et al. [27] | B | 100 %, mean 3.0 months |
N = 0 | ||
Raikin et al. [29] | B | Pre m = 61, post m = 93 |
E = 9, G = 4, F = 1 |
N = 1 | |
Saxena et al. [33] | B | 100 %, mean 3.2 months | Pre m = 58, post m = 97 |
N = 1 | |
Tomihara et al. [39] | A | 80 %, mean 2.9 month | Pre m = 78, post m = 93 |
N = 0 | |
Tomihara et al. [39] | C | 54.40 %, mean 3.9 months | Pre m = 77, post m = 89 |
N = 2 | |
Walther et al. [41] | B | 100 % | Pre m = 69, post m = 95 |
N = 0 | |
Wang et al. [42] | D | 100 %, mean 2.8 months | Pre m = 73, post m = 100 |
E = 17 |
N = 0 |
Zhenbo et al. [43] | C | 88 %, mean 4.4 months | Pre m = 56, post m = 88 |
E = 12, G = 11, F = 3 |
N = 0 |
Group A SPR repair | Group B Groove deepening and SPR repair |
p value | Group A + B | |
---|---|---|---|---|
Number of patients |
N = 90 |
N = 120 |
N = 210 | |
Gender | M: 76 (88 %), F: 10 (12 %) | M: 61 (71 %), F: 25 (29 %) | M: 137 (80 %), F: 35 (20 %) | |
a
| ||||
Age | Mean 23 ± 1.5 years | Mean 28 ± 5.8 years |
p = 0.099 | Mean 26 ± 5.1 years |
a
| ||||
AOFAS Pre-operative Post-operative Improvement p value Improvement | Mean 67 ± 12 Mean 93 ± 0.79 Mean 26 ± 13
p = 0.0249 | Mean 60 ± 5.6 Mean 94 ± 2.3 Mean 35 ± 6.4
p = 0.0003 |
p = 0.24 | Mean 63 ± 9.2 Mean 94 ± 1.8 Mean 31 ± 3.3
p < 0.0001 |
a
| ||||
RTS rate | Mean 87 ± 8.9 % | Mean 99 ± 3.7 % |
p = 0.022 | Mean 93 ± 8.4 % |
a
| ||||
RTS time | Mean 3.0 ± 0.070 months | Mean 4.6 ± 2.6 months |
p = 0.44 | Mean 4.1 ± 2.3 months |
a
|