Liu Xiao-Ning, Chang Fei, Zhang Han-Yang, Zhong Zhuan, Xue Pan, Huang Bing-Zhe
Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, Jilin Province, China.
Medicine (Baltimore). 2020 Sep 25;99(39):e22330. doi: 10.1097/MD.0000000000022330.
Widely applied in the treatment of severe ankle arthritis (AA), ankle distraction arthroplasty (ADA) can avoid not only the ankle range of motion loss but also ankle fusion. However, the clinical outcomes of ADA for severe AA are poorly understood. This study aims to present our clinical outcomes of severe AA treated by ADA.
A 53-year-old man suffered right ankle sprain 10 years ago, endured right ankle pain and limited movement for 6 years.
The patient was diagnosed as severe AA.
He received ankle distraction arthroplasty. No adjuvant procedures were performed. The visual analog scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, the short-form (SF)-36 physical component summary (PCS) score and ankle activity score (AAS) were recorded to access the clinical outcomes pre- and postoperatively. Moreover, ankle joint space distance was evaluated on weight-bearing radiographs.
The patient derived effective pain relief and restored a satisfactory range of movement. There was a 13-month follow-up period after frame removal. The AOFAS score improved from 56 preoperatively to 71 postoperatively. The VAS score decreased from 6 prior to surgery to 1 after surgery. The SF-36 PCS was 47.2 and 71.8 pre- and postoperative, respectively. The AAS scores were improved from 3.4 preoperatively to 7.3 postoperatively.
ADA is reliable to achieve pain relief, functional recovery, and serve AA resolution. Besides, it is an alternative to ankle arthrodesis or total ankle arthroplasty in selected patients with severe AA.
踝关节撑开成形术（ADA）广泛应用于重度踝关节关节炎（AA）的治疗，不仅可以避免踝关节活动度丧失，还能避免踝关节融合。然而，对于重度AA的ADA临床疗效了解甚少。本研究旨在展示我们采用ADA治疗重度AA的临床疗效。
一名53岁男性10年前右踝关节扭伤，右踝关节疼痛及活动受限6年。
该患者被诊断为重度AA。
他接受了踝关节撑开成形术。未进行辅助手术。记录视觉模拟量表（VAS）、美国矫形足踝协会（AOFAS）评分、简明健康状况调查量表（SF-36）身体成分总结（PCS）评分和踝关节活动评分（AAS）以评估术前和术后的临床疗效。此外，在负重X线片上评估踝关节间隙距离。
患者疼痛得到有效缓解，恢复了满意的活动范围。拆除外固定架后随访13个月。AOFAS评分从术前的56分提高到术后的71分。VAS评分从术前的6分降至术后的1分。SF-36 PCS评分术前为47.2，术后为71.8。AAS评分从术前的3.4分提高到术后的7.3分。
ADA在实现疼痛缓解、功能恢复及解决AA方面是可靠的。此外，对于选定的重度AA患者，它是踝关节融合术或全踝关节置换术的替代方案。
