Comparison between ankle arthroplasty and ankle arthrodesis in end-stage ankle osteoarthritis

2017 ◽  
Vol 23 ◽  
pp. 58-59
Author(s):  
K. Mikhaylov ◽  
A. Bulatov ◽  
V. Emelyanov ◽  
D. Pliev ◽  
M. Guatsaev ◽  
...  
Keyword(s):  
Ankle Arthrodesis ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
End Stage

scholarly journals Clinical outcomes of surgical treatment for end-stage ankle osteoarthritis in patients aged over 75 years: a multicenter, retrospective study

2022 ◽  
Author(s):  
Kentaro Amaha ◽  
Satoshi Yamaguchi ◽  
Atsushi Teramoto ◽  
Tetsuro Kokubo ◽  
Hiroyuki Seki ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
The Self ◽  
Age Group ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Evaluation Questionnaire ◽  
End Stage

Abstract Background The purpose of this study was to clarify the clinical outcomes of surgical treatment for end-stage ankle osteoarthritis in patients aged ≥75 years and compare the outcomes with those of patients aged <75 years. Methods A total of 148 patients, including 65 post-total ankle arthroplasty and 83 post-ankle arthrodesis patients, were surveyed retrospectively. Clinical outcomes were assessed using the Japanese Society for Surgery of the Foot hindfoot scale and the self-administered foot evaluation questionnaire preoperatively and at the last follow-up. Patient characteristics, including age, sex, body mass index, radiographic severity, and follow-up period, were also assessed. Patients were divided into the older age group (≥75 years) and the younger age group (<75 years). Improvements in outcomes were then compared between the age groups using univariate analysis and analysis of covariance adjusted for patient characteristics. Post-total ankle arthroplasty and post-ankle arthrodesis were analyzed separately. Results All clinical outcome scores improved postoperatively in the older age group for both post-total ankle arthroplasty and post-ankle arthrodesis. For example, scores for pain and pain-related subscale of the self-administered foot evaluation questionnaire improved by 37 points (p < 0.001) for post-total ankle arthroplasty patients and by 35 points for post-ankle arthrodesis (p < 0.001). Furthermore, multivariate analysis showed that the improvements observed in all scores were not different between the older and younger age groups for both post-total ankle arthroplasty and post-ankle arthrodesis patients, except for the Self-Administered Foot Evaluation Questionnaire physical functioning subscale score for post-ankle arthrodesis patients. Conclusions Clinical outcomes improved significantly in post-total ankle arthroplasty and post-ankle arthrodesis patients aged ≥75 years. Moreover, the improvements were similar to those in patients aged <75 years. Therefore, surgical treatment of end-stage ankle osteoarthritis can be a viable treatment option, even in elderly patients.

Validation of the Ankle Osteoarthritis Scale Instrument for Preoperative Evaluation of End-Stage Ankle Arthritis Patients Using Item Response Theory

2019 ◽  
Vol 40 (4) ◽  
pp. 422-429 ◽  
Author(s):  
Guiping Liu ◽  
Alexander C. Peterson ◽  
Kevin Wing ◽  
Trafford Crump ◽  
Alastair Younger ◽  
...  
Keyword(s):  
Item Response Theory ◽  
Item Response ◽  
Ankle Arthrodesis ◽  
Ankle Arthritis ◽  
Response Theory ◽  
Ankle Osteoarthritis ◽  
Differential Item Function ◽  
Ankle Replacement ◽  
End Stage ◽  
Pain Domain

Background: Significant ankle arthritis results in functional limitations and patient morbidity. There is a need to measure symptoms and the impact of interventions on patient’s quality of life using valid and reliable patient-reported measurement instruments. The objective of this research was to validate the Ankle Osteoarthritis Scale instrument in the preoperative setting using factor analysis, item response theory, and differential item function methods. Methods: This research is based on secondary analysis of patients scheduled for ankle arthrodesis or total ankle replacement in Vancouver, Canada. Participants completed the instrument between September 2014 and August 2017. Item response theory was used to estimate item difficulty and discrimination parameters, controlling for study participants’ underlying level of ankle function. Differential item function was examined for sex, age group, and surgery. There were 88 participants. Results: Modification indices suggested that item 10, “walking around the house,” would better fit the pain domain rather than the disability domain. Items in the pain domain displayed a range of discrimination and difficulty. Items in the disability domain exhibited a range of discrimination, though the disability domain had low difficulty. Differential item functioning for sex, age group, and ankle arthrodesis or total ankle replacement appeared to be ignorable. Conclusion: This evaluation of the Ankle Osteoarthritis Scale found the instrument to be a strong measure of the effect of pain and dysfunction among patients with end-stage ankle arthritis, even when removing items 7 and 8, supporting its prior use in numerous clinical studies. Level of Evidence: Level II, prospective comparative study.

A Survey for End-Stage Ankle Arthritis Treatment: Ankle Arthrodesis Versus Ankle Arthroplasty

2020 ◽  
Vol 59 (2) ◽  
pp. 330-336 ◽  
Author(s):  
Kerry Tai ◽  
Christopher Vannabouathong ◽  
Sohail M. Mulla ◽  
Christina L. Goldstein ◽  
Christopher Smith ◽  
...  
Keyword(s):  
Ankle Arthrodesis ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
End Stage

scholarly journals Total ankle arthroplasty and ankle arthrodesis affect the biomechanics of the inner foot differently

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yan Wang ◽  
Duo Wai-chi Wong ◽  
Qitao Tan ◽  
Zengyong Li ◽  
Ming Zhang
Keyword(s):  
Contact Pressure ◽  
Stance Phase ◽  
Peak Stress ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthroplasty ◽  
Plantar Pressure Distribution ◽  
Metatarsal Bones ◽  
Biomechanical Parameters ◽  
End Stage

Abstract Ankle arthrodesis and total ankle arthroplasty are the two primary surgeries for treatment of end-stage degenerative ankle arthritis. The biomechanical effects of them on the inner foot are insufficient to identify which is superior. This study compared biomechanical parameters among a foot treated by ankle arthrodesis, a foot treated by total ankle arthroplasty, and an intact foot using computational analysis. Validated finite element models of the three feet were developed and used to simulate the stance phase of gait. The results showed total ankle arthroplasty provides a more stable plantar pressure distribution than ankle arthrodesis. The highest contact pressure, 3.17 MPa, occurred in the medial cuneonavicular joint in the total ankle arthroplasty foot. Neither of the surgeries resulted in contact pressure increase in the subtalar joint. The peak stress in the metatarsal bones was increased in both surgical models, especially the second and third metatarsals. This study enables us to get visual to the biomechanics inside of an intact foot, and feet treated by total ankle arthroplasty and ankle arthrodesis during walking.

scholarly journals Modern total ankle arthroplasty versus ankle arthrodesis: A systematic review and meta-analysis

2020 ◽  
Vol 12 (3) ◽  
Author(s):  
Cort D. Lawton ◽  
Adam Prescott ◽  
Bennet A. Butler ◽  
Jakob F. Awender ◽  
Ryan S. Selley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Treatment Options ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
P Value ◽  
Eligibility Criteria ◽  
Ankle Arthroplasty ◽  
Significant Difference ◽  
End Stage

The controversy in surgical management of end-stage tibiotalar arthritis with Total Ankle Arthroplasty (TAA) versus Ankle Arthrodesis (AA) has grown in parallel with the evolution of both procedures. No randomized controlled trials exist due to the vast differences in surgical goals, patient expectations, and complication profiles between the two procedures. This makes high quality systematic reviews necessary to compare outcomes between these two treatment options. The aim of this study was to provide a systematic review with meta-analysis of publications reporting outcomes, complications, and revision data following third-generation TAA and/or modern AA published in the past decade. Thirtyfive articles met eligibility criteria, which included 4312 TAA and 1091 AA procedures. This review reports data from a mean follow-up of 4.9 years in the TAA cohort and 4.0 years in the AA cohort. There was no significant difference in overall complication rate following TAA compared to AA (23.6% and 25.7% respectively, P-value 0.31). Similarly, there was no significant difference in revision rate following TAA compared to AA (7.2% and 6.3% respectively, P-value 0.65). Successful treatment of end-stage tibiotalar arthritis requires an understanding of a patients’ goals and expectations, coupled with appropriate patient selection for the chosen procedure. The decision to proceed with TAA or AA should be made on a case-by-case basis following an informed discussion with the patient regarding the different goals and complication profiles for each procedure.

scholarly journals Two-Year Outcomes of Total Ankle Replacement with the Cadence Total Ankle Replacement System

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0015
Author(s):  
Timothy R. Daniels ◽  
Shahin Kayum ◽  
Ryan M. Khan ◽  
Anastasia Sanjevic
Keyword(s):  
Total Ankle Replacement ◽  
Total Ankle Arthroplasty ◽  
X Rays ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Post Surgery ◽  
Ankle Replacement ◽  
Two Component ◽  
Replacement System ◽  
End Stage

Category: Ankle, Ankle Arthritis Introduction/Purpose: Over the last few decades, total ankle replacement (TAR) emerged as a reliable treatment option in end-stage ankle osteoarthritis (OA) while preserving motion and physiological load. The Cadence™ prosthesis, manufactured by Integra LifeSciences, is a two-component, fixed-bearing implant with minimal tibial and talar resection and has been in clinical use since June 2016. The purpose of this study is to assess the two-year validated clinical outcome scores and radiological parameters of the Cadence™ prosthesis at our hospital. Methods: Thirty-one consecutive patients who received the Cadence™ prosthesis between June 2016 and December 31st, 2016 were enrolled. All patients who underwent a primary TAR with the Cadence™ prosthesis and who had at least two years follow- up were included. All surgeries were performed by a single surgeon with experience in total ankle arthroplasty. At the yearly clinical evaluation, patients were administered the Ankle Osteoarthritis Scale (AOS) and the Short Form Health Survey (SF-36), and their radiological outcomes pre and post-surgery were assessed. Results: Thirty-one patients fulfilled the inclusion criteria. Forty ancillary procedures were performed on twenty-four TAR’s. Radiological analyses showed preoperative talar sagittal translation with 25 anterior, 2 posterior, and 4 neutral. Sagittal translation decreased from an average 3.11 mm to 1.0 mm. Eleven ankles had a perioperative talar Varus and Valgus deformity that was corrected, with neutral alignment in all. At the two-year clinic visit, x-rays showed no lucencies or stress fractures and none of the ankles required revision of metal components. The pre and post-operative pain and disability scores displayed major improvement wherein AOS pain scores decreased -20.28 ± 14.34 points from an average of 47.86 points while AOS disability scores decreased -32.11 ± 22.70 from an average of 57.15 points. Conclusion: The overall outcome of the total ankle arthroplasty with the Cadence™ prosthesis showed excellent clinical and radiological outcomes. Compelling clinical evidence shows that the quality of life, functional measures, and pain in patients suffering from end-stage arthritis significantly improved following surgery with the Cadence™ total ankle replacement system. The semi- constrained design of this two-component implant and utilization of biased polyethylene inserts allowed for correction of the talus in both the sagittal (talar anterior / posterior translation) and coronal planes (talar varus / valgus).

scholarly journals Total ankle arthroplasty incorporating a total talar prosthesis

2019 ◽  
Vol 101-B (4) ◽  
pp. 443-446 ◽  
Author(s):  
H. Kurokawa ◽  
A. Taniguchi ◽  
S. Morita ◽  
Y. Takakura ◽  
Y. Tanaka
Keyword(s):  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Custom Made ◽  
The Mean ◽  
Ct Data ◽  
End Stage ◽  
And Function

AimsTotal ankle arthroplasty (TAA) has become the most reliable surgical solution for patients with end-stage arthritis of the ankle. Aseptic loosening of the talar component is the most common complication. A custom-made artificial talus can be used as the talar component in a combined TAA for patients with poor bone stock of the talus. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA.Patients and MethodsTen patients (two men, eight women; ten ankles) treated using a combined TAA between 2009 and 2013 were matched for age, gender, and length of follow-up with 12 patients (one man, 11 women; 12 ankles) who underwent a standard TAA. All had end-stage arthritis of the ankle. The combined TAA features a tibial component of the TNK ankle (Kyocera, Kyoto, Japan) and an alumina ceramic artificial talus (Kyocera), designed using individualized CT data. The mean age at the time of surgery in the combined TAA and standard TAA groups was 71 years (61 to 82) and 75 years (62 to 82), respectively. The mean follow-up was 58 months (43 to 81) and 64 months (48 to 88), respectively. The outcome was assessed using the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Ankle Osteoarthritis Scale (AOS), and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q).ResultsThe mean preoperative JSSF score of the combined TAA and standard TAA groups was 44 (sd 11) and 49 (sd 10), respectively. The mean postoperative JSSF scores were 89 (sd 6.1) and 72 (sd 15), respectively. The mean postoperative JSSF score of the combined TAA group was significantly higher (p = 0.0034). The mean preoperative AOS scores for pain and function in the combined TAA and standard TAA groups were 5.8 (sd 3.3) and 5.5 (sd 3.1), and 8.6 (sd 1.3), and 7.1 (sd 2.9), respectively. The mean postoperative AOS scores of pain and function were 2.5 (sd 2.5) and 2.2 (sd 1.9), and 2.5 (sd 3.3) and 3.4 (sd 2.9), respectively. There were no significant differences between the two groups in terms of postoperative AOS scores. The mean postoperative SAFE-Q scores were: for pain, 76 (sd 23) and 70 (sd 23); for physical function, 66 (sd 25) and 55 (sd 27); for social function, 73 (sd 35) and 62 (sd 34); for shoe-related, 73 (sd 19) and 65 (sd 26); and for general health, 78 (sd 28) and 67 (sd 29), respectively. There were no significant differences between the two groups in terms of postoperative SAFE-Q scores.ConclusionCombined TAA resulted in better clinical results than standard TAA. Cite this article: Bone Joint J 2019;101-B:443–446.

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