Age-Related Outcomes in Total Ankle Arthroplasty: An Analysis of 112 Patients

Cottom, James M.; Graney, Colin; Douthett, Steven M.; Sisovsky, Charles; McConnell, Kelly K.; Plemmons, Britton S.

doi:10.1053/j.jfas.2020.01.004

Cited by 14 publications

(17 citation statements)

References 13 publications

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“…Nevertheless, some recent studies regarding modern TAA have questioned the indication of TAA in young patients. Satisfying outcomes including implant survival and reoperation rates with no significant difference to older patients have been more often reported recently [17][18][19][20]22,23], which is clearly in contrast to the findings of this study. For example, a retrospective cohort study conducted by Gaugler et al using the Hintegra implant in a cohort of 811 patients revealed no significant effect of age on the rates for minor or major revisions, while the clinical outcomes of younger and older patients were comparable with slightly better pain relief in older patients [20].…”

Section: Discussioncontrasting

confidence: 99%

“…Cottom et al investigated several different implants in 112 patients and reported the following complication rates: 18% for patients younger than 55 years, 11.6% for patients aged between 55 and 70 years, and 9.4% for patients older than 70 years at time of surgery. At a mean follow up of 33.9 months, those differences regarding complication rates were not statistically significant [19].…”

Section: Discussionmentioning

confidence: 74%

“…In addition, an improved mobility of the ankle joint is intended to reduce the risk of subsequent OA in adjacent joints [11][12][13][14][15][16]. Due to its inferior survival rates compared to hip and knee replacement, TAA was mainly recommended for older and less active patients in the past [17][18][19]. However, some recent publications have advocated for various TAA implants in young patients [17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

“…Due to its inferior survival rates compared to hip and knee replacement, TAA was mainly recommended for older and less active patients in the past [17][18][19]. However, some recent publications have advocated for various TAA implants in young patients [17][18][19][20][21][22][23]. Gaugler et al and Lee et al reported no significant impact of age at time of surgery on the prothesis survival or reoperation rates for Hintegra TAA (Allegra Orthopaedics, Sydney, NSW, Australia) [17,20].…”

Section: Introductionmentioning

confidence: 99%

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High Reoperation Rate in Mobile-Bearing Total Ankle Arthroplasty in Young Patients

et al. 2022

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Background and Objectives: Due to inferior survival rates compared to hip and knee arthroplasty, total ankle arthroplasty (TAA) was previously mainly recommended for older and less active patients. However, given the encouraging survival rates and clinical outcomes of modern generations of TAA, some authors have also advocated TAA in young patients. Thus, the aim of this study was to evaluate age related reoperation, revision and survival rates of third-generation mobile-bearing TAAs. Materials and Methods: In this retrospective study, 224 consecutive TAA patients with a minimum follow up (FU) of 2 years were analyzed. Patients were retrospectively assigned to two study groups (Group A: age < 50 years; Group B: age ≥ 50 years). Revision was defined as secondary surgery with prothesis component removal, while reoperation was defined as a non-revisional secondary surgery involving the ankle. Results: After a mean FU of 7.1 ± 3.2 years, the reoperation rate (Group A: 22.2%; Group B: 5.3%; p = 0.003) and revision rate (Group A: 36.1%; Group B: 13.8%; p = 0.003) were higher within Group A. An age of under 50 years at time of surgery was associated with higher reoperation (odds ratio (OR): 6.54 (95% CI: 1.96–21.8); p = 0.002) and revision rates (OR: 3.13 (95% CI: 1.22–8.04); p = 0.018). Overall, lower patient age was associated with higher reoperation (p = 0.009) and revision rates (p = 0.001). Conclusions: The ideal indication for TAA remains controversial, especially regarding patient age. The findings of this study show high reoperation and revision rates in patients aged under 50 years at time of surgery. Therefore, the outcomes of this study suggest that the indication for TAA in young patients should be considered very carefully and that the association between low patient age and high reoperation rate should be disclosed to all eligible patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High Reoperation Rate in Mobile-Bearing Total Ankle Arthroplasty in Young Patients

et al. 2022

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“…Giesinger et al found a negative impact of BMI on postoperative improvement in satisfaction scores (27) . Cottom et al imposed a cut-off of 55 years for patient satisfaction (28) . Several authors have doubted the effect of age or BMI on patient satisfaction (29 , 30) .…”

Section: Discussionmentioning

confidence: 99%

A New Prediction Model of Patient Satisfaction After Total Knee Arthroplasty and The Roles of Different Score Systems: A retrospective cohort study

Liu

Yang

Wan

et al. 2021

Preprint

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BACKGROUNDAlthough total knee arthroplasty (TKA) is efficacious treatment for end-stage osteoarthritis, ~20% patients are dissatisfied with the results. We determined which factors contribute to patient satisfaction and compared the various scoring systems before and after surgery.METHODSIn this retrospective cohort study, 545 patients were enrolled and were evaluated preoperatively and 1 year postoperatively. Patient demographics, as well as scores for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form (SF)-12, and 1989 Knee Society Clinical Rating System (KSS) were recorded preoperatively and postoperatively. The possible predictors were introduced into a prediction model. Scores for overall satisfaction and 2011 Knee Society Score(KSS) were also assessed after total knee arthroplasty to identify the accuracy and agreement of the systems.RESULTSThere were 134 male patients and 411 female patients, with an overall prevalence of satisfaction of 83.7% 1 year after surgery. A history of surgery(p<0.001) , 1989 KSS and SF-12 were of the utmost importance in the prediction model, whereas the WOMAC score had a vital role postoperatively(change of WOMAC pain score, p<0.001; change of WOMAC physical function score, p<0.001; postoperative WOMAC pain score, p=0.004). The agreement between assessment of overall satisfaction and 2011 KSS satisfaction assessment was general(Kappa=0.437>0.4, p<0.001). CONCLUSIONA history of surgery, preoperative 1989 KSS and preoperative SF-12 influenced patient satisfaction after primary total knee arthroplasty. We recommend WOMAC (particularly the subscale score of pain) to reflect the overall patient satisfaction postoperatively.

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Arthroscopic all‐inside ligament repair has similar or superior clinical outcomes compared to open repair for chronic ankle instability without concomitant intra‐articular pathology at 5 years follow‐up

Guelfi,

Baalbaki,

Malagelada

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Open ligament repair is widely considered the gold standard treatment for chronic ankle instability. Nevertheless, arthroscopic treatment of ankle instability has gained popularity becoming the preferred technique for many surgeons. This study aimed to compare the clinical outcomes of all-inside arthroscopic versus open lateral ligament repair for chronic ankle instability at 5 years follow-up. Methods Ninety consecutive patients were surgically treated for chronic ankle instability without concomitant intra-articular pathology observed on MRI: 41 patients [median age 28 (range 15-54) years] underwent an open lateral ligament repair (OLR); 49 patients [median age 30 (range 19-47) years] underwent an all-inside arthroscopic ligament repair (ALR). Functional outcomes using the Foot Functional Index (FFI), the American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot Score, and the Foot and Ankle Ability Measure-Sports Subscale (FAAM-SS) were assessed preoperatively and at the latest follow-up. At the latest follow-up, the satisfaction rate and complications were also recorded. ResultsThe mean follow-up was 58 ± 17.6 (range 47-81) months. In both groups FFI, AOFAS and FAAM-SS score significantly improved compared to preoperative values (p < 0.001). There was no statistically significant difference in postoperative outcomes between groups in the AOFAS (n.s) and FAAM-SS (n.s), but the FFI results were significantly better in the ALR group (p < 0.05). No major complications were reported in either group. Conclusion Open and arthroscopic ligament repair to treat chronic ankle instability without concomitant intra-articular pathology produced excellent comparable clinical outcomes at 5 years follow-up. The complications were minimal in both study groups with no significant differences in AOFAS and FAAM-SS scores. However, arthroscopic repair showed significantly better results on the FFI. Therefore, when treating chronic lateral ankle instability, surgeons should consider arthroscopic ligament repair. Level of evidence III.

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Age-Related Outcomes in Total Ankle Arthroplasty: An Analysis of 112 Patients

Cited by 14 publications

References 13 publications

High Reoperation Rate in Mobile-Bearing Total Ankle Arthroplasty in Young Patients

High Reoperation Rate in Mobile-Bearing Total Ankle Arthroplasty in Young Patients

A New Prediction Model of Patient Satisfaction After Total Knee Arthroplasty and The Roles of Different Score Systems: A retrospective cohort study

Arthroscopic all‐inside ligament repair has similar or superior clinical outcomes compared to open repair for chronic ankle instability without concomitant intra‐articular pathology at 5 years follow‐up

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