Croft Stephen, Wing Kevin J, Daniels Timothy R, Glazebrook Mark, Dryden Peter, Younger Alastair, Penner Murray J, Sutherland Jason M
1 Department of Orthopaedics, Memorial University of Newfoundland, Corner Brook, NL, Canada.
2 Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
Foot Ankle Int. 2017 Sep;38(9):939-943. doi: 10.1177/1071100717712891. Epub 2017 Jun 15.
The Ankle Arthritis Score (AAS) is a new patient-reported outcome derived from the Ankle Osteoarthritis Scale (AOS). This study analyzed longitudinally collected data from a cohort of patients in the Canadian Orthopaedic Foot and Ankle Society (COFAS) Ankle Arthritis Study in order to evaluate whether the postoperative AAS is associated with need for revision surgery.
A multicenter, prospective, ankle-reconstruction study enrolled 653 ankles undergoing total ankle replacement (TAR) or ankle arthrodesis (AA). The AAS was given at baseline and annually during postoperative follow-up. Time to revision surgery was modeled using a proportional hazards model. The final sample included 531 ankles in 509 patients.
Sixty-two patients underwent metal-component revision and 8 underwent arthrodesis revision during the follow-up time period. The remaining 461 unrevised ankles (300 TAR, 161 AA) had a minimum follow-up of 2 years (average of 3.4 years). Revision surgery after TAR was found to be associated with a higher postoperative AAS and a longer follow-up. The hazard ratio for the AAS indicated that for every 1-point increase in the score, the rate of revision surgery after TAR was 1 percentage point higher.
TAR patients who reported higher levels of postoperative functional impairment, as indicated by a higher AAS, were more likely to require metal-component revision surgery. After adjustment for other patient factors, the risk of revision surgery increased with length of follow-up after TAR. This study provides further evidence for the utility of the AAS in the clinical setting.
Level III, retrospective cohort study.
踝关节关节炎评分（AAS）是一种新的患者报告结局，源自踝关节骨关节炎量表（AOS）。本研究分析了加拿大足踝骨科协会（COFAS）踝关节关节炎研究队列中纵向收集的数据，以评估术后AAS是否与翻修手术需求相关。
一项多中心、前瞻性踝关节重建研究纳入了653例接受全踝关节置换（TAR）或踝关节融合术（AA）的踝关节。在基线时及术后随访期间每年进行AAS评分。使用比例风险模型对翻修手术时间进行建模。最终样本包括509例患者的531个踝关节。
在随访期间，62例患者接受了金属部件翻修，8例接受了关节融合翻修。其余461个未翻修的踝关节（300个TAR，161个AA）的最短随访时间为2年（平均3.4年）。发现TAR术后的翻修手术与较高的术后AAS及较长的随访时间相关。AAS的风险比表明，评分每增加1分，TAR术后的翻修手术率就提高1个百分点。
AAS较高表明术后功能障碍水平较高的TAR患者更有可能需要进行金属部件翻修手术。在对其他患者因素进行调整后，TAR术后的翻修手术风险随随访时间的延长而增加。本研究为AAS在临床环境中的实用性提供了进一步证据。
III级，回顾性队列研究。
