Total ankle replacement may improve shoe wear scores at 5 years vs. ankle arthrodesis
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Key takeaways:
- Patients who had total ankle replacement had improved shoe wear comfort scores at 5-year follow-up compared with patients who had ankle arthrodesis.
- The procedures had similar results at 2-year follow-up.
LOUISVILLE, Ky. — Results presented here showed patients who underwent total ankle replacement had improved patient-reported shoe wear scores at 5-year follow-up compared with patients who underwent ankle arthrodesis.
“We can see both ankle arthrodesis and total ankle replacement improve the ability to wear shoes comfortably in patients with end-stage ankle arthritis,” Madeleine Willegger, MD, said in her presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting. “But comparing both of those treatments at the 5-year follow-up, total ankle replacement patients had better shoe wear comfort scores, especially those who already had adjacent joint arthritis, in terms of [Canadian Orthopaedic Foot and Ankle Society] COFAS type 4 grades.”
Willegger and colleagues retrospectively reviewed prospectively collected data from the COFAS database on 152 patients with end-stage ankle arthritis who underwent either total ankle arthrodesis (n = 74) or total ankle replacement (n = 78) between September 2004 and August 2017. To assess ankle arthritis levels, researchers utilized the COFAS classification system, which includes four ascending categories from least to most ankle arthritis.
“Type 1 is an isolated ankle arthritis with no deformity. Type 2 is ankle arthritis with intra-articular deformity in terms of various valgus alignment. Type 3 would be a proximal or distal deformity related to the ankle arthritis, and type 4 is the most severe form with already adjacent joint arthritis,” Willegger said.
Willegger and colleagues also evaluated patient-reported outcome scores through the Musculoskeletal Outcomes Data Evaluation and Management System questionnaire, the Ankle Osteoarthritis Scale and the shoe comfort score.
At 2-year follow-up, the ankle arthrodesis and total ankle replacement groups had similar improvements in patient-reported outcome scores and shoe comfort score with no statistically significant differences, according to Willegger. However, she said patients who underwent total ankle replacement had improved shoe wear scores at 5-year follow-up compared with patients who had ankle arthrodesis.
“Patients who have a COFAS type 4 with already adjacent joint arthritis show a significant improvement when they receive total ankle replacement compared to the fusion group, especially after 5-years of follow-up, which was significant,” Willegger said.
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Willegger M, et al. Effects of ankle arthrodesis versus total ankle arthroplasty on patient’s shoe-wear - What fits better? Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 20-23, 2023; Louisville, Kentucky.
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