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Reviving the debate: Articular cartilage preservation during disarticulation at the lower limb? A systematic review
Laurens K Aerden1, Sander Wuite2, Sabrina Houthoofd3
1Departement of Orthopeadic Surgery, University Hospitals Leuven, Leuven, Belgium.
Background:
The need for preservation(P) or removal(R) of articular cartilage during disarticulations remains unanswered.
Methods:
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.
Results:
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.
Conclusions:
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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