Cheung T, Din A, Zubairy A
Medical Student, University of Central Lancashire, United Kingdom.
Specialty Trainee Year 6 in Trauma & Orthopaedics, North West Deanery, United Kingdom.
J Orthop. 2020 May 11;20:286-292. doi: 10.1016/j.jor.2020.03.030. eCollection 2020 Jul-Aug.
Total ankle replacement (TAR) is a high-risk procedure with significant revision rates, post-op complications and implant failures. Long term follow-up data is less available for TAR compared to other joint replacement surgeries. To identify optimal follow-up parameters for patients with TAR, we conducted a study on the clinical outcomes and patient-reported outcome measurements (PROMs) in patients who had TAR performed in a non-designer's centre belonging to one of the hospitals of East Lancashire Hospitals NHS Trust (ELHT).
60 TAR procedures were identified. Clinical outcomes being studied include post-op ankle range of movement (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scores, reoperation/revision rates, radiological parameters and general surgical outcomes. A Kaplan-Meier survival analysis was also conducted. PROMs data included the EQ-5D index and the Manchester-Oxford Foot Questionnaire (MOX-FQ).
Ankle range of movement and AOFAS scores improved from pre-op to post-op with statistical significance. The reoperation rate and revision rate were 3.3% and 8.3% respectively. 5-year survival of implant was 97.3% and 10-year survival was 84.2%. Overall PROMs data showed improvement from pre-op to post-op.
The clinical outcomes of TARs were comparable with conventional literature. Improvements in clinical, radiological and patient-reported outcomes were observed from pre-op to post-op. Further follow-up studies are required to assess the long-term survival of implants.
全踝关节置换术（TAR）是一种高风险手术，翻修率、术后并发症及植入物失败率均较高。与其他关节置换手术相比，TAR的长期随访数据较少。为确定TAR患者的最佳随访参数，我们对在东兰开夏郡国民保健服务信托基金（ELHT）旗下一家医院的非设计中心接受TAR手术的患者的临床结局和患者报告结局测量（PROMs）进行了一项研究。
确定了60例TAR手术。所研究的临床结局包括术后踝关节活动范围（ROM）、美国矫形足踝协会（AOFAS）踝-后足评分、再次手术/翻修率、放射学参数及一般手术结局。还进行了Kaplan-Meier生存分析。PROMs数据包括EQ-5D指数和曼彻斯特-牛津足部问卷（MOX-FQ）。
踝关节活动范围和AOFAS评分从术前到术后均有改善，具有统计学意义。再次手术率和翻修率分别为3.3%和8.3%。植入物的5年生存率为97.3%，10年生存率为84.2%。总体PROMs数据显示从术前到术后有所改善。
TAR的临床结局与传统文献相当。从术前到术后观察到临床、放射学及患者报告结局均有改善。需要进一步的随访研究来评估植入物的长期生存率。
