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Total ankle arthroplasty versus ankle arthrodesis: a comparative analysis of arc of movement and functional outcomes.
Bone Joint J. 2016 May; 98-B(5):634-40.BJ

Abstract

AIMS

Few reports compare the contribution of the talonavicular articulation to overall range of movement in the sagittal plane after total ankle arthroplasty (TAA) and tibiotalar arthrodesis. The purpose of this study was to assess changes in ROM and functional outcomes following tibiotalar arthrodesis and TAA.

PATIENTS AND METHODS

Patients who underwent isolated tibiotalar arthrodesis or TAA with greater than two-year follow-up were enrolled in the study. Overall arc of movement and talonavicular movement in the sagittal plane were assessed with weight-bearing lateral maximum dorsiflexion and plantarflexion radiographs. All patients completed Short Form-12 version 2.0 questionnaires, visual analogue scale for pain (VAS) scores, and the Foot and Ankle Ability Measure (FAAM).

RESULTS

In all, 41 patients who underwent TAA and 27 patients who underwent tibiotalar arthrodesis were enrolled in the study. The mean total arc of movement was 34.2° (17.0° to 59.1°) with an average contribution from the talonavicular joint of 10.5° (1.2° to 28.8°) in the TAA cohort. The average total arc of movement was 24.3° (6.9° to 44.3°) with a mean contribution from the talonavicular joint of 22.8° (5.6° to 41.4°) in the arthrodesis cohort. A statistically significant difference was detected for both total sagittal plane movement (p = 0.00025), and for talonavicular motion (p < 0.0001). A statistically significant lower VAS score (p = 0.0096) and higher FAAM (p = 0.01, p = 0.019, respectively) was also detected in the TAA group.

CONCLUSION

TAA preserves more anatomical movement, has better pain relief and better patient-perceived post-operative function compared with patients undergoing fusion. The relative increase of talonavicular movement in fusion patients may play a role in the outcomes compared with TAA and may predispose these patients to degenerative changes over time.

TAKE HOME MESSAGE

TAA preserves more anatomic sagittal plane motion and provides greater pain relief and better patient-perceived outcomes compared with ankle arthrodesis. Cite this article: Bone Joint J 2016;98-B:634-40.

Authors+Show Affiliations

Rothman Institute, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246, USA.Allegheny General Hospital, 320 E North Ave, Pittsburgh, PA 15212, USA.Marshall University, 1600 Medical Center Dr, Huntington, WV 25701, USA.Sidney Kimmel Medical College at Thomas Jefferson University, 1020 Walnut Street, Philadelphia, PA 19107, USA.Rothman Institute, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27143734

Citation

Pedowitz, D I., et al. "Total Ankle Arthroplasty Versus Ankle Arthrodesis: a Comparative Analysis of Arc of Movement and Functional Outcomes." The Bone & Joint Journal, vol. 98-B, no. 5, 2016, pp. 634-40.
Pedowitz DI, Kane JM, Smith GM, et al. Total ankle arthroplasty versus ankle arthrodesis: a comparative analysis of arc of movement and functional outcomes. Bone Joint J. 2016;98-B(5):634-40.
Pedowitz, D. I., Kane, J. M., Smith, G. M., Saffel, H. L., Comer, C., & Raikin, S. M. (2016). Total ankle arthroplasty versus ankle arthrodesis: a comparative analysis of arc of movement and functional outcomes. The Bone & Joint Journal, 98-B(5), 634-40. https://doi.org/10.1302/0301-620X.98B5.36887
Pedowitz DI, et al. Total Ankle Arthroplasty Versus Ankle Arthrodesis: a Comparative Analysis of Arc of Movement and Functional Outcomes. Bone Joint J. 2016;98-B(5):634-40. PubMed PMID: 27143734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Total ankle arthroplasty versus ankle arthrodesis: a comparative analysis of arc of movement and functional outcomes. AU - Pedowitz,D I, AU - Kane,J M, AU - Smith,G M, AU - Saffel,H L, AU - Comer,C, AU - Raikin,S M, PY - 2015/07/13/received PY - 2015/11/13/accepted PY - 2016/5/5/entrez PY - 2016/5/5/pubmed PY - 2017/1/31/medline KW - Ankle KW - Arthritis KW - Arthrodesis KW - Arthroplasty KW - Motion KW - Movement SP - 634 EP - 40 JF - The bone & joint journal JO - Bone Joint J VL - 98-B IS - 5 N2 - AIMS: Few reports compare the contribution of the talonavicular articulation to overall range of movement in the sagittal plane after total ankle arthroplasty (TAA) and tibiotalar arthrodesis. The purpose of this study was to assess changes in ROM and functional outcomes following tibiotalar arthrodesis and TAA. PATIENTS AND METHODS: Patients who underwent isolated tibiotalar arthrodesis or TAA with greater than two-year follow-up were enrolled in the study. Overall arc of movement and talonavicular movement in the sagittal plane were assessed with weight-bearing lateral maximum dorsiflexion and plantarflexion radiographs. All patients completed Short Form-12 version 2.0 questionnaires, visual analogue scale for pain (VAS) scores, and the Foot and Ankle Ability Measure (FAAM). RESULTS: In all, 41 patients who underwent TAA and 27 patients who underwent tibiotalar arthrodesis were enrolled in the study. The mean total arc of movement was 34.2° (17.0° to 59.1°) with an average contribution from the talonavicular joint of 10.5° (1.2° to 28.8°) in the TAA cohort. The average total arc of movement was 24.3° (6.9° to 44.3°) with a mean contribution from the talonavicular joint of 22.8° (5.6° to 41.4°) in the arthrodesis cohort. A statistically significant difference was detected for both total sagittal plane movement (p = 0.00025), and for talonavicular motion (p < 0.0001). A statistically significant lower VAS score (p = 0.0096) and higher FAAM (p = 0.01, p = 0.019, respectively) was also detected in the TAA group. CONCLUSION: TAA preserves more anatomical movement, has better pain relief and better patient-perceived post-operative function compared with patients undergoing fusion. The relative increase of talonavicular movement in fusion patients may play a role in the outcomes compared with TAA and may predispose these patients to degenerative changes over time. TAKE HOME MESSAGE: TAA preserves more anatomic sagittal plane motion and provides greater pain relief and better patient-perceived outcomes compared with ankle arthrodesis. Cite this article: Bone Joint J 2016;98-B:634-40. SN - 2049-4408 UR - https://www.unboundmedicine.com/medline/citation/27143734/Total_ankle_arthroplasty_versus_ankle_arthrodesis:_a_comparative_analysis_of_arc_of_movement_and_functional_outcomes_ L2 - https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.98B5.36887?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -