Haleem Amgad M, Galal Sherif, Nwawka Ogonna K, Balagadde Angela, Borst Eugene W, Do Huong T, Mintz Douglas N, Fragomen Austin T, Rozbruch S Robert
Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, United States.
Limb Lengthening and Complex Reconstruction Service, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, Cornell University, New York, United States.
Strategies Trauma Limb Reconstr. 2020 Sep-Dec;15(3):157-162. doi: 10.5005/jp-journals-10080-1512.
Ankle distraction arthroplasty has emerged as an alternative treatment for ankle arthritis. There are few reports on the magnetic resonance imaging (MRI) findings after distraction arthroplasty. This study sought to determine whether there are positive changes on MRI after ankle distraction and improvements on X-ray. Additionally, patient-reported outcomes and joint range of motion (ROM) after ankle distraction are described.
Thirty-two patients (mean age 49 years) who underwent ankle distraction had pre-operative and one-year postoperative MRIs, which were graded using a modified whole-organ magnetic resonance imaging score (WORMS). Ankle joint space and ROM were measured. A non-validated three-item questionnaire was administered to assess functional outcomes.
Although the anterior quadrant of the ankle showed a trend to improvement in cartilage morphology on the postoperative MRI, the WORMS did not demonstrate a significant difference in any of its subcategories. While reduction in joint osteophytes was observed and maintained short term, this was mainly due to resection intraoperatively. X-rays revealed a significant increase in joint space, and there was a significant increase in ankle dorsiflexion. Eight-seven percent of the patients were satisfied with their functional outcome.
At short-term follow-up, MRI scores after ankle distraction arthroplasty did not demonstrate significant improvement despite positive changes on X-ray and improved clinical outcomes and ankle ROM. Further study on larger patient numbers with longer follow-up is required.
IV, Case Series.
Haleem AM, Galal S, Nwawka OK, . Short-term Results of Magnetic Resonance Imaging after Ankle Distraction Arthroplasty. Strategies Trauma Limb Reconstr 2020;15(3):157-162.
踝关节撑开成形术已成为踝关节关节炎的一种替代治疗方法。关于撑开成形术后磁共振成像（MRI）表现的报道较少。本研究旨在确定踝关节撑开术后MRI是否有阳性改变以及X线是否有改善。此外，还描述了踝关节撑开术后患者报告的结局和关节活动范围（ROM）。
32例接受踝关节撑开术的患者（平均年龄49岁）术前行MRI检查，术后1年再次行MRI检查，采用改良的全器官磁共振成像评分（WORMS）进行分级。测量踝关节间隙和ROM。采用一份未经验证的三项问卷评估功能结局。
尽管术后MRI显示踝关节前象限软骨形态有改善趋势，但WORMS在其任何亚类中均未显示出显著差异。虽然观察到关节骨赘减少并在短期内得以维持，但这主要是由于术中切除。X线显示关节间隙显著增加，踝关节背屈明显增加。87%的患者对其功能结局满意。
在短期随访中，尽管X线有阳性改变、临床结局和踝关节ROM有所改善，但踝关节撑开成形术后的MRI评分并未显示出显著改善。需要对更多患者进行更长时间的随访研究。
IV，病例系列。
Haleem AM, Galal S, Nwawka OK, . Ankle Distraction Arthroplasty后磁共振成像的短期结果。Strategies Trauma Limb Reconstr 2020;15(3):157 - 162.
