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Does Severe Ankle Deformity Affect the Outcomes of a 4th Generation Total Ankle Prosthesis? A 2- Year Follow-Up
CATEGORY: Ankle Arthritis INTRODUCTION/PURPOSE: Fourth generation ankle replacements benefit from improved surgical technique, respect for bony preservation, and increased surgeon awareness of operative indications. In some studies, pre-operative degree of deformity has been reported to influence su...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660440/ http://dx.doi.org/10.1177/2473011421S00677 |
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author | Gross, Christopher E. Friscia, David A. Doty, Jesse F. Vora, Anand M. Strasser, Nicholas L. |
author_facet | Gross, Christopher E. Friscia, David A. Doty, Jesse F. Vora, Anand M. Strasser, Nicholas L. |
author_sort | Gross, Christopher E. |
collection | PubMed |
description | CATEGORY: Ankle Arthritis INTRODUCTION/PURPOSE: Fourth generation ankle replacements benefit from improved surgical technique, respect for bony preservation, and increased surgeon awareness of operative indications. In some studies, pre-operative degree of deformity has been reported to influence survivorship, pain, and functional outcomes. The purpose of this multi-institutional study was to evaluate whether pre- operative deformity affects prospectively collected patient reported outcome measures (PROMs) of a fourth-generation total ankle replacement. METHODS: Patients presenting for a total ankle replacement at 9 institutions were prospectively enrolled and implanted in a variety of academic and private settings. Each patient received an INFINITY ankle prosthesis. (Styker, Memphis, TN, USA). The degree of deformity was radiographically classified pre-operatively as severe if ankle varus or valgus was greater than 10° in the coronal plane. PROMs were recorded pre-operatively and at 6 months, 12 months, and 24-month intervals. The following PROMs were collected: Ankle Osteoarthritis Score (AOS), PROMIS Global Physical Health, and Foot and Ankle Outcome Score (FAOS). The preoperative and latest follow-up scores for patients with two years of follow-up were analyzed. RESULTS: A total of 147 patients were enrolled in the study. Fifty-two patients exhibited a pre-operative ankle deformity of greater than 10° varus or valgus. Eighty-eight patients had 24 months of follow-up. All patients with severe deformity had significant improvements in all domains of the AOS, PROMIS, and FAOS Scores (p<0001). The degree of deformity, ankle instability, or hindfoot arthritis did not impact the PROMs (AOA p=.2661, PROMIS p=.543, FAOS p=.684) in those with 2-year follow-up.There were three revisions with varying degrees of deformity. Two patients had revisions for aseptic loosening (6o valgus and 10o varus). One patient had a revision for tibial subsidence (11o varus). CONCLUSION: Severe pre-operative deformity did not impact PROMs in patients undergoing implantation with a 4th generation total ankle replacement. In carefully selected patients, greater deformity did not necessarily correlate with an increased need for revision surgery. |
format | Online Article Text |
id | pubmed-9660440 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-96604402022-11-15 Does Severe Ankle Deformity Affect the Outcomes of a 4th Generation Total Ankle Prosthesis? A 2- Year Follow-Up Gross, Christopher E. Friscia, David A. Doty, Jesse F. Vora, Anand M. Strasser, Nicholas L. Foot Ankle Orthop Article CATEGORY: Ankle Arthritis INTRODUCTION/PURPOSE: Fourth generation ankle replacements benefit from improved surgical technique, respect for bony preservation, and increased surgeon awareness of operative indications. In some studies, pre-operative degree of deformity has been reported to influence survivorship, pain, and functional outcomes. The purpose of this multi-institutional study was to evaluate whether pre- operative deformity affects prospectively collected patient reported outcome measures (PROMs) of a fourth-generation total ankle replacement. METHODS: Patients presenting for a total ankle replacement at 9 institutions were prospectively enrolled and implanted in a variety of academic and private settings. Each patient received an INFINITY ankle prosthesis. (Styker, Memphis, TN, USA). The degree of deformity was radiographically classified pre-operatively as severe if ankle varus or valgus was greater than 10° in the coronal plane. PROMs were recorded pre-operatively and at 6 months, 12 months, and 24-month intervals. The following PROMs were collected: Ankle Osteoarthritis Score (AOS), PROMIS Global Physical Health, and Foot and Ankle Outcome Score (FAOS). The preoperative and latest follow-up scores for patients with two years of follow-up were analyzed. RESULTS: A total of 147 patients were enrolled in the study. Fifty-two patients exhibited a pre-operative ankle deformity of greater than 10° varus or valgus. Eighty-eight patients had 24 months of follow-up. All patients with severe deformity had significant improvements in all domains of the AOS, PROMIS, and FAOS Scores (p<0001). The degree of deformity, ankle instability, or hindfoot arthritis did not impact the PROMs (AOA p=.2661, PROMIS p=.543, FAOS p=.684) in those with 2-year follow-up.There were three revisions with varying degrees of deformity. Two patients had revisions for aseptic loosening (6o valgus and 10o varus). One patient had a revision for tibial subsidence (11o varus). CONCLUSION: Severe pre-operative deformity did not impact PROMs in patients undergoing implantation with a 4th generation total ankle replacement. In carefully selected patients, greater deformity did not necessarily correlate with an increased need for revision surgery. SAGE Publications 2022-11-11 /pmc/articles/PMC9660440/ http://dx.doi.org/10.1177/2473011421S00677 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Gross, Christopher E. Friscia, David A. Doty, Jesse F. Vora, Anand M. Strasser, Nicholas L. Does Severe Ankle Deformity Affect the Outcomes of a 4th Generation Total Ankle Prosthesis? A 2- Year Follow-Up |
title | Does Severe Ankle Deformity Affect the Outcomes of a 4th Generation
Total Ankle Prosthesis? A 2- Year Follow-Up |
title_full | Does Severe Ankle Deformity Affect the Outcomes of a 4th Generation
Total Ankle Prosthesis? A 2- Year Follow-Up |
title_fullStr | Does Severe Ankle Deformity Affect the Outcomes of a 4th Generation
Total Ankle Prosthesis? A 2- Year Follow-Up |
title_full_unstemmed | Does Severe Ankle Deformity Affect the Outcomes of a 4th Generation
Total Ankle Prosthesis? A 2- Year Follow-Up |
title_short | Does Severe Ankle Deformity Affect the Outcomes of a 4th Generation
Total Ankle Prosthesis? A 2- Year Follow-Up |
title_sort | does severe ankle deformity affect the outcomes of a 4th generation
total ankle prosthesis? a 2- year follow-up |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660440/ http://dx.doi.org/10.1177/2473011421S00677 |
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