Debridement and hinged motion distraction is superior to debridement alone in patients with ankle osteoarthritis: a prospective randomized controlled trial.

Autor: Herrera-Perez M; Orthopaedic Department, University Hospital of Canary Islands, Carretera La Cuesta s/n, 38320, San Cristóbal de La Laguna, Tenerife, Spain. herrera42@gmail.com., Alrashidi Y; Orthopaedic Department, College of Medicine, Taibah University, Medina, Kingdom of Saudi Arabia., Galhoum AE; Nasser Institute for Research and Treatment, Cairo, Egypt., Kahn TL; Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA., Valderrabano V; Orthopaedic Department, Schmerzklinik Basel, Basel, Switzerland., Barg A; Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA. alexej.barg@hsc.utah.edu.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2019 Sep; Vol. 27 (9), pp. 2802-2812. Date of Electronic Publication: 2018 Sep 27.
DOI: 10.1007/s00167-018-5156-3
Abstrakt: Purpose: To evaluate and compare complication rates and postoperative outcomes in patients with ankle debridement alone vs. debridement and hinged ankle distraction arthroplasty.
Methods: A total of 50 patients with posttraumatic ankle osteoarthritis (OA) with a mean age of 40.0 ± 8.5 years were included into this prospective randomized study: 25 patients in ankle debridement alone group and 25 patients in debridement and hinged ankle distraction group. The mean follow-up was 46 ± 12 months (range 36-78 months). The clinical and radiographic outcomes were evaluated at the 6-month and 3-year follow-up using the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, SF-36 quality of life score, and van Dijk OA classification. A Kaplan-Meier survival analysis was performed to calculate the 3-year and 5-year survival rates.
Results: Both patient groups experienced significant pain relief, functional improvement, and improvement in quality of life postoperatively. In total, 26 major secondary procedures were performed. The overall survival rates in the debridement and ankle distraction group were 19 of 25 (74%) and 15 of 25 (59%) at 3 years and 5 years, respectively. The overall survival rates in the ankle debridement alone group were 12 of 25 (49%) and 9 of 25 (34%) at 3 years and 5 years, respectively.
Conclusions: The study demonstrated comparable postoperative functional outcome and quality of life. However, rate of postoperative revision surgery was substantially higher in ankle debridement alone group.
Level of Evidence: Randomized controlled study, Level I.
Databáze: MEDLINE
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