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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

03.01.2021 | Trauma Surgery

Superiority of upper ankle arthrodesis over total ankle replacement in the treatment of end-stage posttraumatic ankle arthrosis

verfasst von: Sebastian Fischer, Alexander Klug, Philipp Faul, Reinhard Hoffmann, Sebastian Manegold, Yves Gramlich

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 3/2022

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Abstract

Purpose

Surgical treatment of end-stage posttraumatic upper ankle arthrosis is challenging. Highly variable revision rates have been reported with total ankle arthroplasty (TAA) of the upper ankle joint. The aim of this retrospective study was to compare revision rates with tibiotalar arthrodesis (TTA) and TAA with a prosthesis to determine the superior treatment approach.

Methods

Data for 148 patients (96 males and 52 females) with end-stage posttraumatic upper ankle arthrosis—including 88 treated with TTA and 60 with TAA between 2008 and 2013, with a mean follow-up of 59 months—were analysed. Bone fusion was confirmed by x-ray radiography and computed tomography.

Results

The overall revision rate was 28%; the rate was higher with TAA (42%) than with TTA (18%). The TAA group showed an increase in revisions from 12- to 24-month postsurgery. The most common cause of revision in the TAA group was cysts (20%), and the most frequent reason for revision was nonunion (8%). Mean American Orthopaedic Foot and Ankle Society (AOFAS) and Foot and Ankle Outcome (FAO) scores in all patients were 55.5 and 53.1, respectively, with no significant difference between the TTA and TAA groups (p > 0.05). In nine cases (15%) the prosthesis was explanted or converted to TTA. TAA patients who underwent conversion to TTA had worse outcomes (AOFAS score = 39; FAO score = 35.29).

Conclusion

TAA is associated with a high rate of revisions, especially from the 2nd year postsurgery. Therefore, TTA is the treatment of choice for end-stage posttraumatic upper ankle arthrosis.

Level of evidence Level III, comparative series.

Saltzman CL, Salamon ML, Blanchard GM et al (2005) Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J 25:44–46PubMedPubMedCentral

Christensen JC, Schuberth JM, Powell EG (2016) Talolisthesis in end stage ankle arthrosis. Foot Ankle Surg 22:200–204. https://doi.org/10.1016/j.fas.2015.09.002CrossRefPubMed

LaMothe J, Baxter JR, Gilbert S et al (2017) Effect of complete syndesmotic disruption and deltoid injuries and different reduction methods on ankle joint contact mechanics. Foot Ankle Int 38:694–700. https://doi.org/10.1177/1071100717696360CrossRefPubMed

Krähenbühl N, Siegler L, Deforth M et al (2019) Subtalar joint alignment in ankle osteoarthritis. Foot Ankle Surg 25:143–149. https://doi.org/10.1016/j.fas.2017.10.004CrossRefPubMed

Kim C-W, Gwak H-C, Kim J-H et al (2018) Radiologic factors affecting ankle pain before and after total knee arthroplasty for the varus osteoarthritic knee. J Foot Ankle Surg 57:865–869. https://doi.org/10.1053/j.jfas.2018.02.002CrossRefPubMed

Kim HJ, Suh DH, Yang JH et al (2017) Total ankle arthroplasty versus ankle arthrodesis for the treatment of end-stage ankle arthritis: a meta-analysis of comparative studies. Int Orthop 41:101–109. https://doi.org/10.1007/s00264-016-3303-3CrossRefPubMed

Schuh R, Hofstaetter J, Krismer M et al (2012) Total ankle arthroplasty versus ankle arthrodesis. Comparison of sports, recreational activities and functional outcome. Int Orthop 36:1207–1214. https://doi.org/10.1007/s00264-011-1455-8CrossRefPubMed

Tai K, Vannabouathong C, Mulla SM et al (2020) A survey for end-stage ankle arthritis treatment: ankle arthrodesis versus ankle arthroplasty. J Foot Ankle Surg 59:330–336. https://doi.org/10.1053/j.jfas.2019.09.007CrossRefPubMed

Barg A, Wimmer MD, Wiewiorski M et al (2015) Total ankle replacement. Dtsch Arztebl Int 112:177–184. https://doi.org/10.3238/arztebl.2015.0177CrossRefPubMedPubMedCentral

10.

Lee G-W, Lee K-B (2020) Does gender influence the outcomes of total ankle arthroplasty in patients with ankle osteoarthritis? J Orthop Surg Res 15:207–217. https://doi.org/10.1186/s13018-020-01731-5CrossRefPubMedPubMedCentral

11.

Jensen J, Frøkjær J, Gerke O et al (2014) Evaluation of periprosthetic bone cysts in patients with a Scandinavian total ankle replacement: weight-bearing conventional digital radiographs versus weight-bearing multiplanar reconstructed fluoroscopic imaging. AJR Am J Roentgenol 203:863–868. https://doi.org/10.2214/AJR.13.11539CrossRefPubMed

12.

Kofoed H (2014) Is ankle arthrodesis or total ankle replacement the better treatment for end stage arthrosis? Foot Ankle Surg 20:1. https://doi.org/10.1016/j.fas.2013.12.003CrossRefPubMed

13.

Veljkovic AN, Daniels TR, Glazebrook MA et al (2019) Outcomes of total ankle replacement, arthroscopic ankle arthrodesis, and open ankle arthrodesis for isolated non-deformed end-stage ankle arthritis. J Bone Joint Surg Am 101:1523–1529. https://doi.org/10.2106/JBJS.18.01012CrossRefPubMed

14.

Maffulli N, Longo UG, Locher J et al (2017) Outcome of ankle arthrodesis and ankle prosthesis: a review of the current status. Br Med Bull 124:91–112. https://doi.org/10.1093/bmb/ldx042CrossRefPubMed

15.

Evans JT, Evans JP, Walker RW et al (2019) How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet 393:647–654. https://doi.org/10.1016/S0140-6736(18)31665-9CrossRefPubMedPubMedCentral

16.

Stewart MG, Green CL, Adams SB et al (2017) Midterm results of the Salto Talaris total ankle arthroplasty. Foot Ankle Int 38:1215–1221. https://doi.org/10.1177/1071100717719756CrossRefPubMed

17.

Krishnapillai S, Joling B, Sierevelt IN et al (2019) Long-term follow-up results of Buechel-Pappas ankle arthroplasty. Foot Ankle Int 40:553–561. https://doi.org/10.1177/1071100719828379CrossRefPubMed

18.

Cottom JM, Graney CT, Douthett SM et al (2020) Age-related outcomes in total ankle arthroplasty: an analysis of 112 patients. J Foot Ankle Surg. https://doi.org/10.1053/j.jfas.2020.01.004CrossRefPubMed

19.

Norvell DC, Ledoux WR, Shofer JB et al (2019) Effectiveness and safety of ankle arthrodesis versus arthroplasty: a prospective multicenter study. J Bone Joint Surg Am 101:1485–1494. https://doi.org/10.2106/JBJS.18.01257CrossRefPubMed

20.

Popelka S, Sosna A, Vavřík P et al (2016) Eleven-year experience with total ankle arthroplasty. Acta Chir Orthop Traumatol Cech 83:74–83PubMed

21.

Lee G-W, Lee K-B (2019) Outcomes of total ankle arthroplasty in ankles with >20° of coronal plane deformity. J Bone Joint Surg Am 101:2203–2211. https://doi.org/10.2106/JBJS.19.00416CrossRefPubMed

22.

Arcângelo J, Guerra-Pinto F, Pinto A et al (2019) Peri-prosthetic bone cysts after total ankle replacement. A systematic review and meta-analysis. Foot Ankle Surg 25:96–105. https://doi.org/10.1016/j.fas.2017.11.002CrossRefPubMed

23.

Lampley A, Gross CE, Green CL et al (2016) Association of cigarette use and complication rates and outcomes following total ankle arthroplasty. Foot Ankle Int 37:1052–1059. https://doi.org/10.1177/1071100716655435CrossRefPubMed

24.

Gougoulias N, Khanna A, Maffulli N (2010) How successful are current ankle replacements?: a systematic review of the literature. Clin Orthop Relat Res 468:199–208. https://doi.org/10.1007/s11999-009-0987-3CrossRefPubMed

25.

Yang C, Xu X, Zhu Y et al (2016) A long-term study of the effect of subtalar arthrodesis on the ankle and hindfoot joints. J Am Podiatr Med Assoc 106:47–53. https://doi.org/10.7547/14-002CrossRefPubMed

26.

Gross CE, Lewis JS, Adams SB et al (2016) Secondary arthrodesis after total ankle arthroplasty. Foot Ankle Int 37:709–714. https://doi.org/10.1177/1071100716641729CrossRefPubMed

27.

Mohammad HR, Debrock W, Mellon SJ, Cooke P (2019) Response to review article published titled “Total ankle arthroplasty versus ankle arthrodesis - a comparison of outcomes over the last decade.” J Orthop Surg Res 14:142–152. https://doi.org/10.1186/s13018-019-1190-1CrossRefPubMedPubMedCentral

28.

Egrise F, Parot J, Bauer C et al (2020) Complications and results of the arthrodesis after total ankle arthroplasty failure: a retrospective monocentric study of 12 cases. Eur J Orthop Surg Traumatol 30:373–381. https://doi.org/10.1007/s00590-019-02561-wCrossRefPubMed

29.

Lachman JR, Ramos JA, Adams SB et al (2018) Patient-reported outcomes before and after primary and revision total ankle arthroplasty. Foot Ankle Int 99:1071100718794956. https://doi.org/10.1177/1071100718794956CrossRef

30.

Gross C, Erickson BJ, Adams SB, Parekh SG (2015) Ankle arthrodesis after failed total ankle replacement: a systematic review of the literature. Foot Ankle Spec 8:143–151. https://doi.org/10.1177/1938640014565046CrossRefPubMed

31.

Richter D, Krähenbühl N, Susdorf R et al (2020) What are the indications for implant revision in three-component total ankle arthroplasty? Clin Orthop Relat Res. https://doi.org/10.1097/CORR.0000000000001517CrossRef

32.

Smith RW (2019) What! Another Short-Term Follow-up Paper on Total Ankle Arthroplasty?: Commentary on an article by Daniel C. Norvell, PhD, et al.: "Effectiveness and Safety of Ankle Arthrodesis Versus Arthroplasty. A Prospective Multicenter Study". J Bone Joint Surg Am, 101:e84. doi: https://doi.org/10.2106/JBJS.19.00700

Titel: Superiority of upper ankle arthrodesis over total ankle replacement in the treatment of end-stage posttraumatic ankle arthrosis
verfasst von: Sebastian Fischer
Alexander Klug
Philipp Faul
Reinhard Hoffmann
Sebastian Manegold
Yves Gramlich
Publikationsdatum: 03.01.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 3/2022
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-020-03714-x

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Superiority of upper ankle arthrodesis over total ankle replacement in the treatment of end-stage posttraumatic ankle arthrosis