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[Ankle arthrodesis - clinical, radiological and biomechanical aspects with special regard to the adjacent joints].
Z Orthop Unfall. 2012 Dec; 150(6):588-93.ZO

Abstract

BACKGROUND

Arthrodesis as well as total arthroplasty are well established but controversially discussed treatment options for end-stage osteoarthritis of the ankle joint. For guidance concerning the significance of both surgical procedures we have correlated our clinical, radiological and biomechanical data with an up-to-date literature review.

MATERIAL AND METHODS

15 patients after arthrodesis because of an isolated end-stage osteoarthritis of the ankle joint were followed clinically and radiologically 4 (1.9-8.8) years after surgery. To evaluate the outcome, different scores (AOFAS, Kellgren and Lawrence) were used. In the second part of the study a dynamic foot model was implemented to simulate a foot strike in vitro utilising a cadaver foot. By controlling 6 extrinsic tendons via steel cables, a hydraulic force application and a moving ground plate, a foot strike was simulated. Intraarticular compression load was measured in the talonavicular and calcaneocuboid joints with pressure-sensitive foils.

RESULTS

The mean AOFAS score for the subcategory pain was 28 ± 12 points. In the subcategory function the patients had a mean score of 38 ± 9 points summing up to a mean total AOFAS score of 66 ± 18 points. Six patients showed radiological evidence of degeneration of the talonavicular joint. For these patients the Kellgren and Lawrence score was 2.3 (1-4) points higher than for the opposite side. Concerning the subtalar joint in 6 patients the Kellgren and Lawrence score was 1.6 (1-3) points higher compared to the non-surgery side. In contrast we noted only one case with degeneration of the calcaneocuboid joint. The native trial utilising the foot model revealed a continuous rise of load transmission in both parts of the Chopart joint. After performing an arthrodesis, load transmission rose significantly in the second half of the foot strike concerning the talonavicular joint whereas the calcaneocuboid joint showed a decreased transmission of load.

CONCLUSION

Referring to published data complication rates after ankle arthrodesis are lower compared to total ankle arthroplasty whilst adjacent joint degeneration of the subtalar and talonavicular joints is more common.

Authors+Show Affiliations

Orthopädie und Unfallchirurgie, Katharinenhospital, Stuttgart.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

ger

PubMed ID

23303612

Citation

Suckel, A, et al. "[Ankle Arthrodesis - Clinical, Radiological and Biomechanical Aspects With Special Regard to the Adjacent Joints]." Zeitschrift Fur Orthopadie Und Unfallchirurgie, vol. 150, no. 6, 2012, pp. 588-93.
Suckel A, Burger A, Wülker N, et al. [Ankle arthrodesis - clinical, radiological and biomechanical aspects with special regard to the adjacent joints]. Z Orthop Unfall. 2012;150(6):588-93.
Suckel, A., Burger, A., Wülker, N., & Wünschel, M. (2012). [Ankle arthrodesis - clinical, radiological and biomechanical aspects with special regard to the adjacent joints]. Zeitschrift Fur Orthopadie Und Unfallchirurgie, 150(6), 588-93. https://doi.org/10.1055/s-0032-1327931
Suckel A, et al. [Ankle Arthrodesis - Clinical, Radiological and Biomechanical Aspects With Special Regard to the Adjacent Joints]. Z Orthop Unfall. 2012;150(6):588-93. PubMed PMID: 23303612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Ankle arthrodesis - clinical, radiological and biomechanical aspects with special regard to the adjacent joints]. AU - Suckel,A, AU - Burger,A, AU - Wülker,N, AU - Wünschel,M, Y1 - 2013/01/09/ PY - 2013/1/11/entrez PY - 2013/1/11/pubmed PY - 2013/8/2/medline SP - 588 EP - 93 JF - Zeitschrift fur Orthopadie und Unfallchirurgie JO - Z Orthop Unfall VL - 150 IS - 6 N2 - BACKGROUND: Arthrodesis as well as total arthroplasty are well established but controversially discussed treatment options for end-stage osteoarthritis of the ankle joint. For guidance concerning the significance of both surgical procedures we have correlated our clinical, radiological and biomechanical data with an up-to-date literature review. MATERIAL AND METHODS: 15 patients after arthrodesis because of an isolated end-stage osteoarthritis of the ankle joint were followed clinically and radiologically 4 (1.9-8.8) years after surgery. To evaluate the outcome, different scores (AOFAS, Kellgren and Lawrence) were used. In the second part of the study a dynamic foot model was implemented to simulate a foot strike in vitro utilising a cadaver foot. By controlling 6 extrinsic tendons via steel cables, a hydraulic force application and a moving ground plate, a foot strike was simulated. Intraarticular compression load was measured in the talonavicular and calcaneocuboid joints with pressure-sensitive foils. RESULTS: The mean AOFAS score for the subcategory pain was 28 ± 12 points. In the subcategory function the patients had a mean score of 38 ± 9 points summing up to a mean total AOFAS score of 66 ± 18 points. Six patients showed radiological evidence of degeneration of the talonavicular joint. For these patients the Kellgren and Lawrence score was 2.3 (1-4) points higher than for the opposite side. Concerning the subtalar joint in 6 patients the Kellgren and Lawrence score was 1.6 (1-3) points higher compared to the non-surgery side. In contrast we noted only one case with degeneration of the calcaneocuboid joint. The native trial utilising the foot model revealed a continuous rise of load transmission in both parts of the Chopart joint. After performing an arthrodesis, load transmission rose significantly in the second half of the foot strike concerning the talonavicular joint whereas the calcaneocuboid joint showed a decreased transmission of load. CONCLUSION: Referring to published data complication rates after ankle arthrodesis are lower compared to total ankle arthroplasty whilst adjacent joint degeneration of the subtalar and talonavicular joints is more common. SN - 1864-6743 UR - https://www.unboundmedicine.com/medline/citation/23303612/[Ankle_arthrodesis___clinical_radiological_and_biomechanical_aspects_with_special_regard_to_the_adjacent_joints]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0032-1327931 DB - PRIME DP - Unbound Medicine ER -