Total ankle arthroplasty may improve function, pain relief in patients with arthritis
Click Here to Manage Email Alerts
For patients with end-stage ankle arthritis, total ankle arthroplasty provided significant improvements in overall function, ankle-specific function and pain relief at 4 years after surgery, according to published results.
From May 2012 to May 2015, researchers analyzed prospective cohorts of 417 patients undergoing total ankle arthroplasty (TAA) and 103 patients undergoing ankle arthrodesis (AA) for end-stage ankle arthritis. Both procedures were performed by the same group of surgeons, according to the study.
Outcome measures included the foot and ankle ability measure (FAAM) activities of daily living and sports subscales, the SF-36 physical and mental component summary scores, and pain scores.
At 4 years after surgery, both cohorts saw “significant improvement” across all outcome measures; however, the TAA cohort achieved a higher improvement in FAAM activities of daily living, FAAM sports and SF-36 scores. Additionally, the TAA cohort recorded higher mean improvements in pain scores and lower revision rates compared with the AA cohort.
“The improvements were signicantly greater after TAA in nearly every patient-reported measure. These differences are clinically important, particularly in the ankle-specific measures,” the researchers wrote in the study. “Furthermore, 28% more patients who underwent TAA were completely satisfied than those who underwent AA,” they added.
Perspective
Back to Top
In my opinion, Sangeorzan and colleagues’ investigation provides surgeons with the most objective data to council their ankle arthritis patients in deciding between total ankle arthroplasty (TAA) and ankle arthrodesis (AA). Sangeorzan and colleagues’ thorough comparison of TAA and AA confirms that both procedures deliver significant improvements in function and pain, with TAA demonstrating the greater functional improvement at all follow-up time points and the final follow-up at 4 years. Although other authors have suggested similar findings, Sangeorzan and colleagues’ carefully executed investigation using validated outcome measures is the first to support these conclusions at a high level of evidence. Furthermore, the investigators observed that all improvements documented at 2 years were maintained at 4 years, which is important information for surgeons to share with patients following the surgical management of ankle arthritis.
Collapse
Read more about
Click Here to Manage Email Alerts