Modern total ankle arthroplasty versus ankle arthrodesis: A systematic review and meta-analysis

Autor: Cort D. Lawton, Adam Prescott, Bennet A. Butler, Jakob F. Awender, Ryan S. Selley, Robert G. Dekker II, Earvin S. Balderama, Anish R. Kadakia
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Orthopedic Reviews, Vol 12, Iss 3 (2020)
Druh dokumentu: article
ISSN: 2035-8237
2035-8164
DOI: 10.4081/or.2020.8279
Popis: The controversy in surgical management of end-stage tibiotalar arthritis with Total Ankle Arthroplasty (TAA) versus Ankle Arthrodesis (AA) has grown in parallel with the evolution of both procedures. No randomized controlled trials exist due to the vast differences in surgical goals, patient expectations, and complication profiles between the two procedures. This makes high quality systematic reviews necessary to compare outcomes between these two treatment options. The aim of this study was to provide a systematic review with meta-analysis of publications reporting outcomes, complications, and revision data following third-generation TAA and/or modern AA published in the past decade. Thirtyfive articles met eligibility criteria, which included 4312 TAA and 1091 AA procedures. This review reports data from a mean follow-up of 4.9 years in the TAA cohort and 4.0 years in the AA cohort. There was no significant difference in overall complication rate following TAA compared to AA (23.6% and 25.7% respectively, P-value 0.31). Similarly, there was no significant difference in revision rate following TAA compared to AA (7.2% and 6.3% respectively, P-value 0.65). Successful treatment of end-stage tibiotalar arthritis requires an understanding of a patients’ goals and expectations, coupled with appropriate patient selection for the chosen procedure. The decision to proceed with TAA or AA should be made on a case-by-case basis following an informed discussion with the patient regarding the different goals and complication profiles for each procedure.
Databáze: Directory of Open Access Journals