Outcomes of Total Ankle Arthroplasty in Moderate and Severe Valgus Deformity
| Autor: | Elizabeth Cody MD, Constantine Demetracopoulos MD, Samuel Adams MD, James DeOrio MD, James Nunley MD, Mark Easley MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Foot & Ankle Orthopaedics, Vol 3 (2018) |
| Druh dokumentu: | article |
| ISSN: | 2473-0114 24730114 |
| DOI: | 10.1177/2473011418S00035 |
| Popis: | Category: Ankle Arthritis Introduction/Purpose: Among patients with end-stage ankle arthritis, total ankle arthroplasty (TAA) utilization has significantly increased in recent years, while ankle arthrodesis utilization has declined. Significant coronal plane deformity is frequently encountered in this patient population, and was previously considered a contraindication to TAA. However, the advent of newer fixed-bearing prostheses, coupled with improved surgical techniques and a better understanding of ligamentous balancing, have allowed surgeons to extend their indications for TAA with respect to deformity correction. Several authors have demonstrated good outcomes from TAA in patients with significant varus deformities, but not specifically in patients with valgus deformities. We aimed to determine the clinical, radiographic, and patient-reported outcomes of patients with moderate to severe valgus deformity who underwent TAA for end-stage ankle arthritis. Methods: Eighty patients with valgus deformities =10 degrees who underwent TAA were retrospectively reviewed. All surgeries were performed by one of three fellowship-trained orthopaedic foot and ankle surgeons with extensive experience in TAA. One of three prostheses were used: INBONE (Wright Medical Technology, Arlington, TN), Salto-Talaris (Integra, Plainsboro, NJ), or the Scandinavian Total Ankle Replacement (STAR; Stryker, Kalamazoo, MI). We assessed the coronal tibiotalar angle on standardized weightbearing radiographs preoperatively, at one year, and at final follow-up. The visual analog scale (VAS) for pain, Short Form (SF)-36 scale, American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scale, and Short Musculoskeletal Function Assessment (SMFA) scores were assessed preoperatively and at final follow-up. Subgroup analyses were performed to determine differences in outcome scores, deformity correction, and maintenance of alignment between patients with moderate (=10 degrees, 20 degrees) preoperative deformity. Complication, reoperation, and revision rates were collected from chart review. Results: Mean preoperative valgus deformity was 15.5 ± 5.0 degrees, and was corrected to a mean 1.2 ± 2.6 degrees of valgus postoperatively (Figure; P |
| Databáze: | Directory of Open Access Journals |
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