Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.
Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Orthop Surg. 2022 May;14(5):937-945. doi: 10.1111/os.13286. Epub 2022 Apr 19.
To evaluate the outcomes of Ilizarov ankle arthrodesis in the treatment of end-stage varus ankle osteoarthritis (OA).
This was a retrospective study of 63 patients with varus ankle OA who underwent Ilizarov ankle arthrodesis between June 2013 and December 2018. There were 24 males and 39 females with an average age of 56.57 ± 4.45 years (range, 47-64 years). Thirty-six cases were affected on the left side, and 27 were affected on the right side. The patients' mean body mass index (BMI) was 25.18 ± 2.93 kg/m . According to the modified Takakura staging criteria, there were 18 cases of stage 3b (28.57%) and 45 cases of stage 4 (71.43%). Nine patients were primary (14.29%), 48 were traumatic (76.19%), and six were caused by rheumatoid OA (9.52%). Functional assessments were performed according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Ankle Osteoarthritis Scale (AOS), and visual analogue scale (VAS). The tibial anterior surface angle (TAS), coronal plane tibial-talar angle (CPT), talar tilt angle (TT), deformity angle (DA), and tibial lateral surface angle (TLS) were assessed on X-ray films.
The average operation time was 147.84 ± 13.67 min (range, 135-168 min). The average follow-up time was 34.24 ± 8.72 months (range, 24-61 months). Bony fusion was achieved in all ankles, and the fusion time was 12.43 ± 1.99 weeks on average. The average AOFAS score at the final follow-up increased from 42.14 ± 8.66 to 80.90 ± 6.80. The average VAS score and AOS pain and disability scores at the final follow-up decreased from 7.29 ± 1.27 to 2.24 ± 0.94, from 67.94 ± 7.68 to 27.92 ± 5.82, and from 71.64 ± 9.37 to 41.32 ± 8.99, respectively. The average TAS, CPT, and TLS at the final follow-up increased from 77.76° ± 4.44° to 89.81° ± 1.25°, from 69.04° ± 3.73° to 90.43° ± 1.80°, and from 82.14° ± 3.77° to 88.67° ± 2.50°, respectively. The average TT and DA at the final follow-up decreased from 8.76° ± 4.30° to 2.05° ± 1.28° and from 20.95° ± 3.73° to 1.57° ± 0.93°, respectively. Three patients developed superficial pin tract infections, all settled with local dressing and antibiotic treatment. Two patients were found to have subtalar arthritis and underwent conservative treatment.
Ankle arthrodesis using the Ilizarov technique is efficient in treating end-stage varus ankle OA.
评估伊里扎洛夫踝关节融合术治疗终末期内翻踝骨关节炎（OA）的效果。
这是一项回顾性研究，纳入了 2013 年 6 月至 2018 年 12 月期间接受伊里扎洛夫踝关节融合术的 63 例内翻踝 OA 患者。其中男性 24 例，女性 39 例，平均年龄 56.57±4.45 岁（范围，47-64 岁）。36 例为左侧，27 例为右侧。患者平均体重指数（BMI）为 25.18±2.93 kg/m2。根据改良 Takakura 分期标准，3b 期 18 例（28.57%），4 期 45 例（71.43%）。9 例为原发性（14.29%），48 例为创伤性（76.19%），6 例为类风湿性 OA（9.52%）。根据美国矫形足踝协会（AOFAS）踝-后足评分、踝骨关节炎量表（AOS）和视觉模拟评分（VAS）进行功能评估。在 X 线片上评估胫骨前表面角（TAS）、冠状面胫骨距骨角（CPT）、距骨倾斜角（TT）、畸形角（DA）和胫骨外侧表面角（TLS）。
平均手术时间为 147.84±13.67 min（范围，135-168 min）。平均随访时间为 34.24±8.72 个月（范围，24-61 个月）。所有踝关节均达到骨性融合，平均融合时间为 12.43±1.99 周。末次随访时 AOFAS 评分平均从 42.14±8.66 增加到 80.90±6.80。末次随访时 VAS 评分和 AOS 疼痛和残疾评分平均从 7.29±1.27 降至 2.24±0.94、67.94±7.68 降至 27.92±5.82 和 71.64±9.37 降至 41.32±8.99。末次随访时 TAS、CPT 和 TLS 平均从 77.76°±4.44°增加到 89.81°±1.25°、69.04°±3.73°增加到 90.43°±1.80°和 82.14°±3.77°增加到 88.67°±2.50°。末次随访时 TT 和 DA 平均从 8.76°±4.30°减少到 2.05°±1.28°和 20.95°±3.73°减少到 1.57°±0.93°。3 例患者发生浅表钉道感染，均经局部换药和抗生素治疗治愈。2 例患者发现距下关节炎，行保守治疗。
伊里扎洛夫技术踝关节融合术治疗终末期内翻踝骨关节炎疗效确切。
