Kołodziej Łukasz, Ciechanowicz Dawid, Wójtowicz Maria, Król Marta, Szabałowska Małgorzata, Kwiatkowski Sebastian, Szymczak Mateusz, Czajka Radomir
Department of Orthopaedics, Traumatology and Musculoskeletal Oncology, Pomeranian Medical University, 71-281 Szczecin, Poland.
ST Medical Clinic, 71-004 Szczecin, Poland.
J Clin Med. 2023 Jul 24;12(14):4872. doi: 10.3390/jcm12144872.
The partial dislocation of the talus from the calcaneus and navicular bones is a primary factor leading to a prolonged overpronation during weightbearing. This study aimed to assess the possibility of returning to physical activity and long-term patient satisfaction after an extra-osseous talotarsal stabilization (EOTTS) procedure with a HyProCure sinus tarsi implant for partial talotarsal joint dislocation (TTJ).
A total of 41 adult patients (61 feet), with an average age of 46.41, were included and treated surgically with EOTTS as a stand-alone surgery. Physical activity and functional scores were assessed pre- and post-operatively using questionnaires-the UCLA Activity Score, Symptom-Related Ankle Activity Scale (SAAS), Sports Frequency Score (SFS), Lower Extremity Functional Scale (LEFS), and VAS scale. Satisfaction was assessed on a ten-point scale. The follow-up period was on average 8.61 years (from 7.33 to 10.31).
EOTTS had a positive impact on physical activity, and a high rate of patient satisfaction (8.95 ± 1.9) was noted. The treatment led to a reduction in foot pain, as well as an increase in SAAS and LEFS scores (15,6% and 19,3%, respectively, <0.01). The VAS pain score decreased by 18,6% ( <0.001). SFS and UCLA scores showed a small increase, but it was not statistically significant. A positive correlation was noted between patient satisfaction and time of physical activity per week (R = 0.33, =0.04), and also between patient satisfaction and SAAS scores (R = 0.43, =0.005). Pain from other joints (knee, hip) was eliminated or reduced in 40% of patients after surgery.
EOTTS with a HyProCure implant is an effective long-term treatment option for partial talotarsal joint dislocation, leading to a reduction in foot pain and increased patient satisfaction, and allowing for a return to physical activity.
距骨与跟骨和舟状骨的部分脱位是负重期间导致长期过度内旋的主要因素。本研究旨在评估采用HyProCure跗骨窦植入物进行骨外距跗关节稳定术（EOTTS）治疗部分距跗关节脱位（TTJ）后恢复体育活动的可能性以及患者的长期满意度。
共纳入41例成年患者（61足），平均年龄46.41岁，均接受EOTTS单独手术治疗。术前和术后使用问卷评估体育活动和功能评分，包括加州大学洛杉矶分校活动评分、症状相关踝关节活动量表（SAAS）、运动频率评分（SFS）、下肢功能量表（LEFS）和视觉模拟量表（VAS）。满意度采用十分制进行评估。随访期平均为8.61年（7.33至10.31年）。
EOTTS对体育活动有积极影响，患者满意度较高（8.95±1.9）。该治疗使足部疼痛减轻，SAAS和LEFS评分增加（分别为15.6%和19.3%，P<0.01）。VAS疼痛评分下降了18.6%（P<0.001）。SFS和加州大学洛杉矶分校评分略有增加，但无统计学意义。患者满意度与每周体育活动时间之间存在正相关（R=0.33，P=0.04），患者满意度与SAAS评分之间也存在正相关（R=0.43，P=0.005）。40%的患者术后其他关节（膝、髋）疼痛消除或减轻。
采用HyProCure植入物的EOTTS是治疗部分距跗关节脱位的一种有效的长期治疗选择，可减轻足部疼痛，提高患者满意度，并允许恢复体育活动。
