• Zixing Bai, Yanjun Yang, Si Chen, Yongli Dong, Xuhan Cao, Weikai Qin, and Weidong Sun.
• Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
• Medicine (Baltimore). 2021 Mar 12; 100 (10): e24998e24998.

BackgroundAnkle fusion is the primary treatment for advanced ankle arthritis. With the advancement of arthroscopy technology, ankle arthroscopy fusion has shown many advantages over traditional surgery. However, there are few related studies globally, and evidence-based medicine is needed to verify the reliability and feasibility of ankle arthroscopy fusion.ObjectiveTo compare the clinical efficacy and safety of arthroscopic ankle arthrodesis and open ankle arthrodesis.MethodsWe searched the databases of PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure [CNKI], Wanfang Database, and VIP Database for published prospective or retrospective controlled studies of arthroscopic-assisted ankle fusion in the treatment of advanced ankle arthritis. The dates were limited from the construction of the library to June 30, 2019. Literature was included based on the principles and methods of evidence-based medicine. Literature retrieval, data extraction, and quality assessment were performed by 2 independent reviewers using the Cochrane 5.1 risk bias assessment tool. The methodological bias of the literature was evaluated, and a meta-analysis was using by RevMan 5.3 software.ResultsA total of 18 studies and 1102 patients were included in the study, including 551 in the arthroscopic surgery group and 551 in the open surgery group. Arthroscopy-assisted surgery for advanced ankle arthritis was more effective than open surgery in terms of fusion rate (odd ratio[OR] = 3.32, 95% confidence interval[CI]:2.16, 5.10), fusion time (mean difference[MD] = -2.31, 95% CI:-4.63, -2.21), intraoperative blood loss (MD = -43.37, 95%CI: -48.49, -38.25), hospital stay (MD = -1.80, 95%CI: -2.28, -1.33), and visual analog scale score (MD = -1.75, 95%CI: -2.04, -1.46). In addition, rate of complications (OR = 0.33, 95%CI: 0.21, 0.52) was superior to open ankle fusion (P < .00001).ConclusionArthroscopic ankle arthrodesis has more advantages than open ankle arthrodesis in improving the fusion rate and reducing complications, which is worthy of clinical application.Prospero Registration NumberCRD42020195727.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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