Simultaneous bilateral total ankle arthroplasty seen as comparable to staged procedure
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QUEBEC CITY — Under surgeon expertise in appropriately selected patients, simultaneous bilateral total ankle arthroplasty has comparable outcomes with the staged procedure for patients with bilateral end-stage ankle osteoarthritis.
“Patients with bilateral end-stage ankle arthritis represent a unique population with a higher incidence of primary OA,” Amanda N. Fletcher, MD, MS, said in her presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting. “There have been no previous reports comparing bilateral-stage vs. simultaneous ankle arthroplasty, which was our goal in this study,” she added.
Fletcher and colleagues at Duke University Medical Center performed a comparative cohort study of 50 patients (mean age of 64.3 years) who underwent primary total ankle arthroplasty (TAA) between 2007 and 2019 and had an average follow-up of 52.2 months. Mean time between surgeries was 17.5 months in patients who underwent staged TAA. According to the abstract, 56% of patients (n = 28) had primary OA.
Overall, no significant differences were found between the cohorts in pain, patient-reported outcome measures or perioperative complications. The simultaneous bilateral cohort had a perioperative complication rate of 22% and a reoperation rate of 6%, while the staged cohort had a perioperative complication rate of 24% and a reoperation rate of 5%. Fletcher noted that reoperation-free survival was 94% at 2 years and 88% at 5 years in the simultaneous cohort, while reoperation-free survival was 96% at 2 years and 90% at 5 years in the staged cohort. Both cohorts had 100% failure-free survival rate at 8 years after surgery.
Fletcher said simultaneous TAA warrants further investigation for the potential benefits of decreased anesthesia events, surgery time, tourniquet time, length of stay, recovery time and overall cost.
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Fletcher AN, et al. Comparison of the clinical outcomes and complications of simultaneous vs. staged bilateral total ankle arthroplasty: A single-center comparative cohort study. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 14-17, 2022; Quebec City (hybrid meeting).
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