Comparison of Z-Technique and Sliding Technique for Achilles Tendon Lengthening in Cerebral Palsy with Equinus Deformity: A Meta-Analysis
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Keywords
Z-lengthening, , sliding technique, , achilles lengthening, , cerebral palsy, , equinus deformity
Abstract
Background: Equinus foot deformity in Cerebral Palsy (CP) might cause functional and aesthetic disturbances. Equinus deformity can be managed by achilles tendon lengthening surgery. Currently there is no meta-analysis comparing Z-technique and sliding technique for achilles tendon lengthening. This meta analysis aimed to compare the recurrence and functional outcome of achilles tendon lengthening using Z-technique versus Sliding technique in CP patients with equinus deformity.
Subjects Methods: A meta-analysis was performed according to PRISMA guidelines. We extensively searched Pubmed and CochraneLibrary database from inception up to January 2023. The quality and risk of bias assessment were performed using Joanna Briggs Insitute checklist. Pooled recurrence and AOFAS score were analysed by Rev Man 5.4 software.
Results: We included a total of four studies consisting of two non-randomized clinical trials and two retrospective studies. A total of 271 limbs were involved, with follow up time ranging from 19.5 months into 42 months. Recurrence rate was higher in Z-technique (OR= 3.01, 95% CI1.01 to 18.97, p=0.05). AOFAS was significantly lower in Z-technique (MD=-10.36, (%% CI -13.54 to -7.17, p<0.001)
Conclusion: Based on low quality of evidence, this meta analysis concluded that sliding technique is more recommended compare to Z-technique as it had less recurrence and better AOFAS. However, RCT study is needed to validate this finding.
Citation: Putra, A. S., & Maharjana, M. A. . (2023). Comparison of Z-Technique and Sliding Technique for Achilles Tendon Lengthening in Cerebral Palsy with Equinus Deformity: A Meta-Analysis. Current Opinion, 3(4), 339–345. https://doi.org/10.52845/currentopinion.v3i4.228
Accepted: June 15, 2023; Published: July 25 2023
Copyright: ©2023 Putra, A. S. et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding:Nil
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Agus Suarjaya Putra ,Resident of Orthopaedic and Traumatology Department, Faculty of Medicine Udayana University, Prof. dr. I.G.N.G Ngoerah Hospital, Bali, Indonesia
