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Preservation of the Subtalar Joint Determines Outcomes in a 10-Year Evaluation of Ankle Arthrodesis

Posttraumatic osteoarthritis may lead to surgical fusion of the ankle joint if non-surgical therapy fails. The indication for a fusion of the joint is based on the pain and disability of the patient, radiographic imaging, and surgeon experience, with no strict guidelines. We aimed to compare outcome...

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Autores principales: Sell, Rebecca, Meinert, Magalie, Herrmann, Eva, Gramlich, Yves, Klug, Alexander, Neun, Oliver, Hoffmann, Reinhard, Fischer, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179703/
https://www.ncbi.nlm.nih.gov/pubmed/37176564
http://dx.doi.org/10.3390/jcm12093123
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author Sell, Rebecca
Meinert, Magalie
Herrmann, Eva
Gramlich, Yves
Klug, Alexander
Neun, Oliver
Hoffmann, Reinhard
Fischer, Sebastian
author_facet Sell, Rebecca
Meinert, Magalie
Herrmann, Eva
Gramlich, Yves
Klug, Alexander
Neun, Oliver
Hoffmann, Reinhard
Fischer, Sebastian
author_sort Sell, Rebecca
collection PubMed
description Posttraumatic osteoarthritis may lead to surgical fusion of the ankle joint if non-surgical therapy fails. The indication for a fusion of the joint is based on the pain and disability of the patient, radiographic imaging, and surgeon experience, with no strict guidelines. We aimed to compare outcomes after tibiotalocalcaneal arthrodesis (TTCA) and tibiotalar arthrodesis (TTA) to highlight the functional importance of the subtalar joint. In total, 432 patients with ankle arthrodesis were retrospectively enrolled. Group A (n = 216) underwent TTCA; group B (n = 216) underwent TTA. Demographics, Olerud & Molander Ankle Score (OMAS), Foot Function Index (FFI-D), and Short Form-12 Questionnaire (SF-12) were recorded at a mean follow-up of 6.2 years. The mean OMAS was 50.7; the mean FFI-D was 68.9; the mean SF-12 physical component summary was 39.1. These scores differed significantly between the groups (p < 0.001). The overall revision rate was 18%, primarily for revision of non-union and infection (p < 0.001). Approximately 16% of group A and 26% of group B were able to return to previous work (p < 0.001). Based on significantly worse clinical scores of TTCA compared to TTA and the prolonged downtime and permanent incapacity, the indication for a generous subtalar joint arthrodesis with planned ankle arthrodesis should always be critically examined.
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spelling pubmed-101797032023-05-13 Preservation of the Subtalar Joint Determines Outcomes in a 10-Year Evaluation of Ankle Arthrodesis Sell, Rebecca Meinert, Magalie Herrmann, Eva Gramlich, Yves Klug, Alexander Neun, Oliver Hoffmann, Reinhard Fischer, Sebastian J Clin Med Article Posttraumatic osteoarthritis may lead to surgical fusion of the ankle joint if non-surgical therapy fails. The indication for a fusion of the joint is based on the pain and disability of the patient, radiographic imaging, and surgeon experience, with no strict guidelines. We aimed to compare outcomes after tibiotalocalcaneal arthrodesis (TTCA) and tibiotalar arthrodesis (TTA) to highlight the functional importance of the subtalar joint. In total, 432 patients with ankle arthrodesis were retrospectively enrolled. Group A (n = 216) underwent TTCA; group B (n = 216) underwent TTA. Demographics, Olerud & Molander Ankle Score (OMAS), Foot Function Index (FFI-D), and Short Form-12 Questionnaire (SF-12) were recorded at a mean follow-up of 6.2 years. The mean OMAS was 50.7; the mean FFI-D was 68.9; the mean SF-12 physical component summary was 39.1. These scores differed significantly between the groups (p < 0.001). The overall revision rate was 18%, primarily for revision of non-union and infection (p < 0.001). Approximately 16% of group A and 26% of group B were able to return to previous work (p < 0.001). Based on significantly worse clinical scores of TTCA compared to TTA and the prolonged downtime and permanent incapacity, the indication for a generous subtalar joint arthrodesis with planned ankle arthrodesis should always be critically examined. MDPI 2023-04-25 /pmc/articles/PMC10179703/ /pubmed/37176564 http://dx.doi.org/10.3390/jcm12093123 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sell, Rebecca
Meinert, Magalie
Herrmann, Eva
Gramlich, Yves
Klug, Alexander
Neun, Oliver
Hoffmann, Reinhard
Fischer, Sebastian
Preservation of the Subtalar Joint Determines Outcomes in a 10-Year Evaluation of Ankle Arthrodesis
title Preservation of the Subtalar Joint Determines Outcomes in a 10-Year Evaluation of Ankle Arthrodesis
title_full Preservation of the Subtalar Joint Determines Outcomes in a 10-Year Evaluation of Ankle Arthrodesis
title_fullStr Preservation of the Subtalar Joint Determines Outcomes in a 10-Year Evaluation of Ankle Arthrodesis
title_full_unstemmed Preservation of the Subtalar Joint Determines Outcomes in a 10-Year Evaluation of Ankle Arthrodesis
title_short Preservation of the Subtalar Joint Determines Outcomes in a 10-Year Evaluation of Ankle Arthrodesis
title_sort preservation of the subtalar joint determines outcomes in a 10-year evaluation of ankle arthrodesis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179703/
https://www.ncbi.nlm.nih.gov/pubmed/37176564
http://dx.doi.org/10.3390/jcm12093123
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