10 Year Outcomes of Unilateral vs Bilateral (Staged) Total Ankle Replacement

Autor: Nicole G. Abdul MBChB, BMedSci, MClin Res, MRCS, Jayasree Ramas Ramaskandhan MPT, MSc, Karen Smith MSc, BSc, Mohammad A. Alkhreisat MD, FRCS T&O, Adam P. Bennett MRCS, Malik S. Siddique FRCS (T&O)
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Foot & Ankle Orthopaedics, Vol 7 (2022)
Druh dokumentu: article
ISSN: 2473-0114
24730114
DOI: 10.1177/2473011421S00068
Popis: Category: Ankle Arthritis; Ankle Introduction/Purpose: Comprehensive long-term outcomes of total ankle replacement (TAR) help guide clinicians when they are deciding on the management of patients with more than single joint arthritis. Some patients will only require unilateral TARs, while others will need bilateral TARs. When deciding on treatment plans for patients, it is important to know the long-term surgical outcomes of both of these groups before treatment can be recommended. Currently there is a paucity of literature on long-term outcomes of unilateral versus bilateral TARs. The aim of the study is to assess long-term outcomes in patients who underwent unilateral vs. staged bilateral TARs. Methods: We performed a retrospective review of a prospectively completed hospital registry database for TAR. This consisted of a consecutive series of TARs performed by one senior surgeon from 2006 to December 2010 with 10-years of follow up. Clinical complications, radiological complications (lucency, cysts, and osteolysis), and patient reported outcome measures (WOMAC score, SF-36, general health survey, and patient satisfaction survey) were included for all patients. Outcomes were evaluated pre-operatively and at 1, 3, 5, and 10 years post-operatively. Three component mobile bearing implants were used in all patients. Results: There were 132 unilateral TARs (Group A) vs. 24 staged bilateral TARs (Group B). WOMAC scores significantly improved from pre-op to 1 year for pain (45.3 to 77.8; 52 to 76) function (49.1 to 77.8; 53.6 to 76) and stiffness (39.8 to 67.9; 55 to 65) in both groups respectively (p0.05). Group A reported 16% dissatisfaction with surgery compared to 10% in Group B (p>0.05). At 5 years there were a higher number of radiological and clinical complications in Group A compared to Group B. Conclusion: For patient reported outcomes, staged bilateral TAR patients had more improvement in function at 5 years, and stiffness at 10 years, when compared to unilateral TAR patients. Unilateral TAR patients had higher rates of complications compared to staged bilateral TAR patients at 5 years.A limitation of this study was the smaller size of Group B patients compared to Group A. We will be able to present a detailed breakdown of outcomes at each time point if the abstract is selected for presentation.
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