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Hindfoot Arthritis Progression and Arthrodesis Risk After Total Ankle Replacement.
Foot Ankle Int. 2017 Nov; 38(11):1183-1187.FA

Abstract

BACKGROUND

The purpose of this study was to assess the radiographic progression of subtalar and talonavicular degenerative joint disease in a series of patients who had undergone TAA (total ankle arthroplasty) with minimum follow-up of 5 years.

METHODS

TAA patient radiographs from a single institution were analyzed for peritalar arthritic changes by extrapolating the modified Kellgren Lawrence (KL) grades of the knee to the subtalar and talonavicular joints. Patients were included if they had a minimum of 5 years of follow-up. Patients who had undergone prior arthrodesis of the talonavicular or subtalar joints were excluded. A total of 140 patients with average follow-up of 6.5 years (range, 5.0-8.9 years) were included.

RESULTS

Overall, 27% of patients advanced 1 KL grade at the subtalar joint and 31% of patients increased 1 KL grade at the talonavicular joint. Furthermore, 60% and 66% of patients showed no progression in the subtalar and talonavicular joints, respectively. Two patients progressed greater than 2 KL subtalar arthritis grades and only 2 patients with talonavicular arthritis progressed to the same extent. Sixteen patients went on to require a subtalar arthrodesis compared to 2 requiring a talonavicular fusion (P < .05).

CONCLUSION

This study suggests a moderate but nominal radiographic increase in adjacent subtalar and talonavicular arthritis over a minimum of 5 years after TAA. Future studies require a comparative control group of ankle fusion, but these data may suggest the motion preserved with an arthroplasty diminishes the stresses and compensatory motion incurred during tibiotalar arthrodesis.

LEVEL OF EVIDENCE

Level IV, retrospective case series.

Authors+Show Affiliations

1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.2 Department of Radiology, Duke University Medical Center, Durham, NC, USA.1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.1 Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28810805

Citation

Dekker, Travis J., et al. "Hindfoot Arthritis Progression and Arthrodesis Risk After Total Ankle Replacement." Foot & Ankle International, vol. 38, no. 11, 2017, pp. 1183-1187.
Dekker TJ, Walton D, Vinson EN, et al. Hindfoot Arthritis Progression and Arthrodesis Risk After Total Ankle Replacement. Foot Ankle Int. 2017;38(11):1183-1187.
Dekker, T. J., Walton, D., Vinson, E. N., Hamid, K. S., Federer, A. E., Easley, M. E., DeOrio, J. K., Nunley, J. A., & Adams, S. B. (2017). Hindfoot Arthritis Progression and Arthrodesis Risk After Total Ankle Replacement. Foot & Ankle International, 38(11), 1183-1187. https://doi.org/10.1177/1071100717723130
Dekker TJ, et al. Hindfoot Arthritis Progression and Arthrodesis Risk After Total Ankle Replacement. Foot Ankle Int. 2017;38(11):1183-1187. PubMed PMID: 28810805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hindfoot Arthritis Progression and Arthrodesis Risk After Total Ankle Replacement. AU - Dekker,Travis J, AU - Walton,David, AU - Vinson,Emily N, AU - Hamid,Kamran S, AU - Federer,Andrew E, AU - Easley,Mark E, AU - DeOrio,James K, AU - Nunley,James A, AU - Adams,Samuel B,Jr Y1 - 2017/08/15/ PY - 2017/8/16/pubmed PY - 2018/7/17/medline PY - 2017/8/17/entrez KW - adjacent joint arthritis KW - fixed bearing ankle replacement KW - mobile bearing ankle replacement KW - range of motion KW - total ankle replacement SP - 1183 EP - 1187 JF - Foot & ankle international JO - Foot Ankle Int VL - 38 IS - 11 N2 - BACKGROUND: The purpose of this study was to assess the radiographic progression of subtalar and talonavicular degenerative joint disease in a series of patients who had undergone TAA (total ankle arthroplasty) with minimum follow-up of 5 years. METHODS: TAA patient radiographs from a single institution were analyzed for peritalar arthritic changes by extrapolating the modified Kellgren Lawrence (KL) grades of the knee to the subtalar and talonavicular joints. Patients were included if they had a minimum of 5 years of follow-up. Patients who had undergone prior arthrodesis of the talonavicular or subtalar joints were excluded. A total of 140 patients with average follow-up of 6.5 years (range, 5.0-8.9 years) were included. RESULTS: Overall, 27% of patients advanced 1 KL grade at the subtalar joint and 31% of patients increased 1 KL grade at the talonavicular joint. Furthermore, 60% and 66% of patients showed no progression in the subtalar and talonavicular joints, respectively. Two patients progressed greater than 2 KL subtalar arthritis grades and only 2 patients with talonavicular arthritis progressed to the same extent. Sixteen patients went on to require a subtalar arthrodesis compared to 2 requiring a talonavicular fusion (P < .05). CONCLUSION: This study suggests a moderate but nominal radiographic increase in adjacent subtalar and talonavicular arthritis over a minimum of 5 years after TAA. Future studies require a comparative control group of ankle fusion, but these data may suggest the motion preserved with an arthroplasty diminishes the stresses and compensatory motion incurred during tibiotalar arthrodesis. LEVEL OF EVIDENCE: Level IV, retrospective case series. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/28810805/Hindfoot_Arthritis_Progression_and_Arthrodesis_Risk_After_Total_Ankle_Replacement_ L2 - http://journals.sagepub.com/doi/full/10.1177/1071100717723130?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -