Dabash Sherif, Buksbaum Joshua R, Fragomen Austin, Rozbruch S Robert
Limb Lengthening and Complex Reconstruction Service, Weill Cornell Medical College Department of Orthopaedic Surgery, Hospital for Special Surgery New York, NY 10021, United States.
SUNY Downstate Health Sciences University, College of Medicine, Brooklyn, New York, NY 11226, United States.
World J Orthop. 2020 Mar 18;11(3):145-157. doi: 10.5312/wjo.v11.i3.145.
Post-traumatic osteoarthritis (PTOA) is a complex and painful problem in the foot and ankle. Ninety percent of osteoarthritis cases in the foot and ankle can be classified as post-traumatic. PTOA can affect any of the 33 joints in the foot and the ankle. Distraction arthroplasty is a method for treatment of early arthritic joints without fusing or replacing them and its effectiveness has been well documented. The purpose of this case series is to present our successful experiences and positive results using distraction arthroplasty to treat PTOA in the ankle, subtalar, first metatarsophalangeal, and second tarsometatarsal joints, and to present distraction arthroplasty as a viable alternative to invasive joint sacrificing procedures such as arthrodesis or arthroplasty. Distraction Arthroplasty effectively and safely treats PTOA and improves the stability of joints in the Foot and Ankle. Additionally, the use of bone marrow aspirate concentrate as an adjuvant can improve the long-term functional and structural outcomes of the joint, and can prolong the need for further, more aggressive surgical interventions such as fusion or arthroplasty.
创伤后骨关节炎(PTOA)是足踝部的一个复杂且疼痛的问题。足踝部90%的骨关节炎病例可归类为创伤后骨关节炎。PTOA可影响足部和踝部的33个关节中的任何一个。撑开式关节成形术是一种治疗早期关节炎关节的方法,无需融合或置换关节,其有效性已有充分记录。本病例系列的目的是展示我们使用撑开式关节成形术治疗踝关节、距下关节、第一跖趾关节和第二跗跖关节的PTOA的成功经验和积极结果,并将撑开式关节成形术作为一种可行的替代方案,以替代诸如关节融合术或关节成形术等有创的关节牺牲性手术。撑开式关节成形术有效且安全地治疗PTOA,并改善足踝部关节的稳定性。此外,使用骨髓抽吸浓缩物作为辅助手段可改善关节的长期功能和结构结果,并可延长对诸如融合术或关节成形术等进一步、更激进的手术干预的需求。