The Effect of Three-Component Total Ankle Replacement Malalignment on Clinical Outcome: Pain Relief and Functional Outcome in 317 Consecutive Patients

2011 ◽  
Vol 93 (21) ◽  
pp. 1969-1978 ◽  
Author(s):  
Alexej Barg ◽  
Andreas Elsner ◽  
Andrew E Anderson ◽  
Beat Hintermann
Keyword(s):  
Pain Relief ◽  
Clinical Outcome ◽  
Functional Outcome ◽  
Total Ankle Replacement ◽  
Ankle Replacement

scholarly journals Is End-Stage Ankle Arthrosis Best Managed with Total Ankle Replacement or Arthrodesis? A Systematic Review

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Robert W. Jordan ◽  
Gurdip S. Chahal ◽  
Anna Chapman
Keyword(s):  
Systematic Review ◽  
Functional Outcome ◽  
Controlled Trial ◽  
Ankle Arthrodesis ◽  
Total Ankle Replacement ◽  
Online Databases ◽  
Ankle Replacement ◽  
Comparative Group ◽  
Randomised Controlled ◽  
End Stage

Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA) has been the surgical intervention of choice but the emergence of total ankle replacement (TAR) has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes.Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must be skeletally mature and suffering from ankle arthrosis of any cause. The intervention had to be an uncemented TAR comprising two or three modular components. The comparative group could include any type of ankle arthrodesis, either open or arthroscopic, using any implant for fixation. The study must have reported at least one functional outcome measure.Results. Of the four studies included, two reported some significant improvement in functional outcome in favour of TAR. The complication rate was higher in the TAR group. However, the quality of studies reviewed was poor and the methodological weaknesses limited any definitive conclusions being drawn.Conclusion. The available literature is insufficient to conclude which treatment is superior. Further research is indicated and should be in the form of an adequately powered randomised controlled trial.

Functional Outcome of Meniscal-Bearing Total Ankle Replacement

2008 ◽  
Vol 98 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Maria Grazia Benedetti ◽  
Alberto Leardini ◽  
Matteo Romagnoli ◽  
Lisa Berti ◽  
Fabio Catani ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Gait Analysis ◽  
Functional Outcome ◽  
Daily Living ◽  
Functional Results ◽  
Total Ankle Replacement ◽  
Long Term Results ◽  
Ankle Replacement

Background: Most clinical studies on total ankle replacement (TAR) report assessments based on traditional clinical scores or radiographic analysis. Only a few studies have used modern instrumentation for quantitative functional analysis during the execution of activities of daily living. The aim of this study was to use gait analysis to compare the functional performance of patients who underwent TAR versus a control population. Methods: A retrospective analysis was performed of ten consecutive patients who had undergone meniscal-bearing TAR. Clinical and functional assessments were performed at a mean follow-up of 34 months with a modified Mazur scoring system and state-of-the-art gait analysis. Results: Gait analysis assessment of TAR at medium-term follow-up showed satisfactory results for all patients, with adequate recovery of range of motion. Because the literature reports unsatisfying long-term results, it is important to evaluate these patients over a longer follow-up period. Conclusions: This study showed that TAR yields satisfactory, but not outstanding, general functional results at nearly 3 years’ follow-up. These gait analysis results highlight the importance of integrating in vivo measurements with the standard clinical assessments of patients who underwent TAR while they perform activities of daily living. These results also emphasize the importance of evaluating the functional outcome of TAR over time. (J Am Podiatr Med Assoc 98(1): 19–26, 2008)

A NOVEL TOTAL ANKLE REPLACEMENT: FROM BIOMECHANICS RESEARCH TO CLINICAL OUTCOME

2007 ◽  
Vol 40 ◽  
pp. S93 ◽  
Author(s):  
A. Leardini ◽  
F Catani ◽  
M. Romagnoli ◽  
A. Digennaro ◽  
D. Sarti ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Total Ankle Replacement ◽  
Ankle Replacement

scholarly journals Complications, Reoperations, and Postoperative Outcomes of Simultaneous Supramalleolar Osteotomy and Total Ankle Replacement in Misaligned Osteoarthritic Ankles in Comparison to Total Ankle Replacement Alone

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0005
Author(s):  
Anne-Constance Franz ◽  
Manja Deforth ◽  
Lukas Zwicky ◽  
Christine Schweizer ◽  
Beat Hintermann
Keyword(s):  
Clinical Outcome ◽  
Polyethylene Wear ◽  
Distal Tibia ◽  
Cyst Formation ◽  
Total Ankle Replacement ◽  
Control Group ◽  
Tibial Resection ◽  
Supramalleolar Osteotomy ◽  
Ankle Replacement ◽  
Surface Angle

Category: Ankle Arthritis Introduction/Purpose: A key for success in total ankle replacement (TAR) is a balanced ankle joint with a physiological loading of the implant, minimizing the wear of the polyethylene insert. Theoretically, in ankles with distal tibial deformities, this can be achieved with a correcting tibial resection cut. As an alternative, supramalleolar osteotomy (SMOT) can be used for balancing the ankle during TAR surgery. To date, however, no data exist whether a SMOT in addition to TAR results in better outcome over time, and which are the additional risks with such extensive surgery. The aim of the study was therefore 1) to determine the risk of a simultaneously performed SMOT in comparison to TAR only, and 2) to compare the postoperative clinical outcomes. Methods: Between 2002 and 2014, 23 patients (male, 12; female, 11; mean age 60 [22-72] years) underwent simultaneously a SMOT and a TAR for treatment of a severe misaligned osteoarthritic ankle (tibial anterior surface angle [TAS] <84° [n=9] or >96° [n=1], or tibial lateral surface angle [TLS] <70° [n=13]) (SMOT&TAR group). Statistical matching was applied to extract a subgroup out of 510 TAR patients from our prospectively collected database with the same baseline characteristics, including similar preoperative alignments (control group). The matched 23 TAR patients (male, 16; female, 7; mean age 58 [35 - 79] years) were compared regarding additional procedures, complications and reoperations. Pre- and postoperative alignment measured on radiographs and clinical outcome (range of motion [ROM], pain on the visual analogue scale [VAS] and AOFAS hindfoot score) were compared. Results: While more additional osteotomies were done in the SMOT&TAR group (calcaneus, 5:1; fibula, 7:1), more ligament reconstructions and tendon transfers were done in control group (ligament reconstruction, 0:6; tendon transfer, 0:6). There was no difference, neither in the complication rate nor in the reoperation rate between both groups. However, there was a tendency of instability, subsequent polyethylene wear and cyst formation in the TAR group. The postoperative TAS was closer to neutral in the SMOT&TAR (pre- to postoperatively: 82.9° to 90.4° vs. 82.6° to 87.8°). While ROM was lower in the SMOT&TAR (30°) than in the TAR group (39°) (p=0.01), there was no difference in the clinical outcome (VAS pain 1.2 vs. 1.5 [p=0.58], AOFAS score 82 vs. 82 [p=0.99]). Conclusion: A SMOT performed simultaneously with TAR for the treatment of a severely deformed ankle resulted in a more neutral and better balanced ankle, and it was not associated with a greater risk of complications or reoperations. The only disadvantage was a slightly smaller ROM. Thus, SMOT should be considered in TAR with greater hindfoot deformities at the distal tibia as it is more powerful to address deforming forces. As shown, SMOT and TAR can be done simultaneously without taking greater risks.

Tri-Component, Mobile Bearing, Total Ankle Replacement: Mid-term Functional Outcome and Survival

2012 ◽  
Vol 51 (5) ◽  
pp. 566-569 ◽  
Author(s):  
Rohit Dhawan ◽  
Jake Turner ◽  
Vikas Sharma ◽  
Ramesh K. Nayak
Keyword(s):  
Functional Outcome ◽  
Mobile Bearing ◽  
Total Ankle Replacement ◽  
Ankle Replacement
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