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Improvements in outcomes seen up to 2 years after total ankle arthroplasty
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Improvements in overall sagittal plane range of motion were seen up to 6 months after total ankle arthroplasty, with improvements for measures pain and function seen up to 2 years, according to results published in the Journal of Bone and Joint Surgery.
“Patients undergoing total ankle replacement surgery will obtain the majority of the improvement in range of motion [ROM] and function at 6 months following surgery but continue to improve for at least the first 2 years,” Steven M. Raikin, MD, told Healio.com/Orthopedics.
Raikin and colleagues retrospectively reviewed the charts of 134 patients who underwent total ankle arthroplasty. Investigators included 107 of these patients in the study. Preoperatively and at 3 months, 6 months, 1 year and 2 years postoperatively, investigators measured overall ROM. Patients completed the VAS for pain, foot and ankle ability measure (FAAM) activities of daily living and sports subscales, and the SF-12 physical and mental component summary scores at each interval.
Results showed the mean overall range of motion in the sagittal plane improved from 20.7 preoperatively to 28.3 at 3 months, to 34.3 at 6 months, to 33.3 at 1 year and to 33.3 at 2 years postoperatively. Investigators noted the median preoperative VAS pain score improved at each time point postoperatively. At 6 months and later, the FAAM an SF-12 scores improved compared with preoperative scores. There was an association between an increased ROM and a lower preoperative VAS score and VAS score at 1 year postoperatively. Researchers found increased ROM was associated with a higher FAAM activities of daily living score at 3 months, 1 year and 2 years postoperatively. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.
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Gregory C. Berlet, MD, FRCS(C), FAOA
This single surgeon review of fixed bearing Salto Talaris total ankle arthroplasty was done with the goal of understanding how ankle motion in patients undergoing total ankle replacement patients and patient outcomes correlate. Overall, researchers studied 109 total ankle arthroplasty patients with a minimum of 2-year follow-up for range of motion, as measured by maximal plantar flexion and dorsiflexion weight bearing radiograph views, and validated patient outcome scoring systems completed prospectively.
Sagittal ankle range of motion (ROM) of these patients improved from an average of 20 ° preoperatively to 33 ° at 2 years. Preoperative ROM did not correlate with the ultimate final ankle ROM.
The ROM both preoperatively and postoperatively correlated with the VAS score with higher ROM having less pain. A higher ROM also correlated with a greater improvement of Foot and Ankle Mobility Measure. Overall, ROM did not correlate with SF-12 subset scores.
A greater ROM in the sagittal plane following total ankle arthroplasty correlated with improved function at 1 and 2 years postoperatively and decreased pain 1 year postoperatively. Range of motion improves up to 6 months after total ankle arthroplasty with an average of 33° composite motion in the sagittal plane using the Salto Talaris implant.
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Hendy BA, et al. J Bone Joint Surg Am.2018;doi:10.2106/JBJS.17.01021.
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