Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Orthopedics and Trauma Surgery, Mater Olbia Hospital, 07026 Olbia, Italy.
Medicina (Kaunas). 2023 Feb 11;59(2):344. doi: 10.3390/medicina59020344.
The treatment of end-stage ankle osteoarthritis (OA) and associated hindfoot deformities remains a major challenge for orthopedic surgeons. Numerous techniques and surgical approaches have been proposed for tibiotalar (TT) and tibiotalocalcaneal (TTC) arthrodesis, from arthroscopic to open, as well as numerous devices proposed for internal fixation (retrograde intramedullary nails, cannulated screws, and plating systems). The aim of this study was to retrospectively analyze the results, with at least 18 months of follow-up, with Silverback TT/TTC Plating System Paragon28 in a group of 20 patients with severe OA and hindfoot deformities (mainly secondary post-traumatic OA).
The demographic characteristics and past medical history of the patients were collected and analyzed to identify the cause of the pathology. The degree of OA and deformity were quantified based on foot and ankle weight-bearing radiography and CT examination. Pre- and post-operative clinical and functional scores (ROM, VAS, AOFAS, FFI, and SF-36) and radiographic parameters (anterior distal tibial angle, tibiotalar angle, coronal tibiotalar angle, and hindfoot alignment angle) were evaluated.
All of the patients showed clinical and radiographic fusion at an average of 14 weeks (range 12-48), with improvement in pain and functional scores, without major surgical complications and/or infections.
Despite the limitations of our study, the results with this new plating system showed good results in terms of bone consolidation, post-operative complications, and improvement of pain and quality of life in patients with severe OA and deformities of the ankle and hindfoot.
治疗终末期踝关节骨关节炎（OA）和相关的后足畸形仍然是骨科医生的主要挑战。已经提出了许多用于距下关节（TT）和距下跟骰关节（TTC）融合术的技术和手术方法，从关节镜到开放，以及许多用于内固定的装置（逆行髓内钉、空心螺钉和接骨板系统）。本研究的目的是回顾性分析 20 例严重 OA 和后足畸形（主要是继发创伤后 OA）患者的 Silverback TT/TTC 接骨板系统 Paragon28 的结果，至少随访 18 个月。
收集并分析患者的人口统计学特征和既往病史，以确定病变的原因。根据足踝负重位 X 线和 CT 检查，对 OA 程度和畸形程度进行量化。评估术前和术后的临床和功能评分（ROM、VAS、AOFAS、FFI 和 SF-36）和影像学参数（距骨下前胫骨角、距下关节角、冠状距下关节角和后足对线角）。
所有患者平均在 14 周（12-48 周）时均出现临床和影像学融合，疼痛和功能评分得到改善，无重大手术并发症和/或感染。
尽管本研究存在局限性，但这种新型接骨板系统的结果显示，在骨融合、术后并发症以及改善严重 OA 和后足畸形患者的疼痛和生活质量方面，效果良好。
