Fellowship Trained Foot and Ankle Surgeon, Director, Florida Orthopedic Foot & Ankle Center Fellowship, Sarasota, FL.
Fellowship Trained Foot and Ankle Surgeon, Florida Orthopedic Foot & Ankle Center, Sarasota, FL.
J Foot Ankle Surg. 2024 May-Jun;63(3):337-344. doi: 10.1053/j.jfas.2024.01.001. Epub 2024 Jan 6.
Total ankle arthroplasty continues to gain popularity amongst surgeons and patients as an alternative to arthrodesis. Historically the designs of early implants were plagued with complications and frequently abandoned. Since that time the procedure and materials have undergone significant advancements in both surgical approach as well as design and function of the available implants. In this study, 40 consecutive patients who received a semiconstrained prosthesis with a unique fixed-bearing polyethylene insert were identified. Minimum follow-up was 2 y. Demographic, social, and past medical data was retrospectively reviewed. Concomitant procedures were also recorded. Radiographic analysis included lateral ankle radiograph postoperative range of motion (ROM) with maximum dorsiflexion and maximum plantarflexion weight bearing at the most recent clinic visit. Clinical outcomes included VAS, FFI, and AOFAS scores. Lateral radiographs taken in the office at a minimum 2-y follow-up showed mean maximum dorsiflexion of 11.8 degrees and plantarflexion of 13.9 degrees. VAS, FFI, and AOFAS scores improved from 8.1, 92.9, and 44.8 to 1.4, 15.3, and 90.1 postoperatively, respectively. A total of 2.5% (n = 1) required revision surgery for poly failure, and 5.0% (n = 2) underwent local wound care in the office setting postoperatively and healed without complications. Overall survivorship was 97.5% at the minimum follow-up of 2 y. In conclusion, similar studies have reported survivorship from 90% to 100% with modern ankle implants in short to mid-term follow-up. Although this is a small sample size, our data shows a 97.5% survivorship at 2 y postoperatively with favorable patient-reported statistically significant functional outcome scores, and ankle range of motion consistent with existing literature.
全踝关节置换术作为关节融合术的替代方法,在外科医生和患者中越来越受欢迎。历史上,早期植入物的设计受到并发症的困扰,经常被放弃。从那时起,该手术和材料在手术方法以及现有植入物的设计和功能方面都取得了重大进展。在这项研究中,确定了 40 例连续接受具有独特固定轴承聚乙烯插入物的半约束假体的患者。最低随访时间为 2 年。回顾性回顾了人口统计学、社会和既往医学数据。同时记录了伴随的手术。影像学分析包括术后踝关节侧位片、最大背屈和最大跖屈的踝关节活动范围(ROM),并在最近的临床就诊时进行负重。临床结果包括 VAS、FFI 和 AOFAS 评分。在至少 2 年的随访时在办公室拍摄的侧位片显示,平均最大背屈为 11.8 度,最大跖屈为 13.9 度。VAS、FFI 和 AOFAS 评分分别从术后的 8.1、92.9 和 44.8 改善至 1.4、15.3 和 90.1。共有 2.5%(n=1)因聚醚醚酮失败需要翻修手术,5.0%(n=2)术后在办公室进行局部伤口护理并愈合,无并发症。在最低 2 年的随访中,总体生存率为 97.5%。总之,类似的研究报告在短期至中期随访中,现代踝关节植入物的生存率为 90%至 100%。尽管这是一个小样本量,但我们的数据显示,术后 2 年的生存率为 97.5%,患者报告的功能结果评分具有统计学意义,且踝关节活动范围与现有文献一致。