Patient-specific instrumentation may improve outcomes in total ankle arthroplasty
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Key takeaways:
- Patient-specific instrumentation showed several improvements in total ankle arthroplasty compared with standard instrumentation.
- Improvements included reduced operative time and intraoperative fluoroscopy time.
Published results showed patient-specific instrumentation may decrease operative time, reduce intraoperative fluoroscopy and achieve better postoperative alignment in patients undergoing total ankle arthroplasty.
In a nonrandomized, retrospective cohort study, James Yau, faculty of medical sciences at Newcastle University in England, and colleagues compared patient-reported outcome measures (PROMs) among 159 patients with ankle arthritis undergoing 168 total ankle replacements (Infinity Total Ankle System, Stryker) using either patient-specific instrumentation (PSI; n=61) or standard instrumentation (n=107) between 2014 and 2021. To measure PROMs, patients completed the Manchester-Oxford Foot Questionnaire, Ankle Osteoarthritis Scale and the EuroQol-5D-3L preoperatively, as well as postoperatively at 6 and 12 months. Researchers also gathered data on complications, reoperations, operative time, radiation exposure, preoperative prediction, fluoroscopy time and postoperative alignment by using hospital records.
Yau and colleagues found that PSI reduced operative time, intraoperative fluoroscopy time, tourniquet time and radiation exposure compared with standard instrumentation.
“Any strategy to decrease unnecessary intraoperative fluoroscopy should be encouraged to reduce patient and surgeon exposure to harmful radiation and diminish cancer risks,” the researchers wrote in the study.
PSI was also associated with improved postoperative alignment and significant improvements in the walking/standing domain of the Manchester-Oxford Foot Questionnaire, according to researchers.
“In conclusion, we believe that this study supports the use of PSI to decrease operative time, reduce intraoperative fluoroscopy and achieve better postoperative alignment,” the researchers wrote in the study. “Longer-term studies are required to demonstrate the effect on overall PROMs and implant survivorship,” they added.
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Yau J, et al. Foot Ankle Spec. 2023;doi:10.1177/19386400231179124.
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