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Fixed equinus deformity showed no negative impact on clinical results of ankle arthroplasty

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BOSTON — Research presented at the American Orthopaedic Foot & Ankle Society Annual Meeting demonstrated preoperative fixed equinus deformity did not negatively affect clinical outcomes of total ankle arthroplasty.

Jack Allport

“Postoperatively, there was no statistically significant difference between [the neutral and fixed equinus deformity group] scores, although there was a trend for ... worse scores with regard to stiffness in the equinus group,” Jack Allport, MBChB, said during his presentation. “Contrary to the recent [National Joint Registry] NJR data, we found there was no difference in revision rates between the two groups.”

Allport and colleagues performed a retrospective cohort study of 164 patients who underwent primary total ankle arthroplasty with the Mobility total ankle arthroplasty system (DePuy),which has a mobile-bearing prosthesis. The mean follow-up was 61.6 months. Patient-reported outcome measure scores (PROMS) assessed included foot and ankle outcome score; WOMAC pain, function and stiffness scores; SF-36 scores and patient satisfaction. Preoperative lateral weight-bearing X-rays were used to screen for fixed equinus deformity. Investigators used clinical records to confirm a diagnosis of fixed equinus deformity. There were 144 patients categorized as neutral and 20 patients were diagnosed with fixed equinus deformity.

Patients in the fixed equinus group compared with those in the neutral group were significantly younger; however, there was no difference between the groups with regard to BMI or follow-up length. Baseline scores were not different except for WOMAC stiffness. Investigators noted the fixed equinus group had significantly worse stiffness. Both groups had similar PROMS, change from baseline and patient satisfaction in all domains. No difference was seen between the groups with regard to the revision rates. – by Monica Jaramillo

Reference:

Allport J, et al. Ankle Arthroplasty: Patient-reported outcomes in preoperative fixed equinus. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 11-14, 2018; Boston.

Disclosure: Allport reports no relevant financial disclosures.