Arthroscopic debridement for the osteoarthritic ankle

Ogilvie-Harris, D.J.; Sekyi-Otu, Ato

doi:10.1016/0749-8063(95)90197-3

Cited by 58 publications

(21 citation statements)

References 14 publications

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“…Most important, in the randomized controlled study, joint distraction showed a better clinical outcome than debridement alone. This is consistent with the findings that debridement in late stage OA has generally little benefit (26). In the controlled study, the 3 patients from the debridement group who, because of lack of efficacy, were treated with joint distraction within 1 year reported significant clinical benefit after joint distraction.…”

Section: Discussionsupporting

confidence: 78%

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study

Marijnissen¹,

Roermund²,

Melkebeek³

et al. 2002

Arthritis & Rheumatism

136

125

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Objective. Osteoarthritis (OA) is a degenerative, disabling joint disease that affects >10% of the adult population. No effective disease-modifying treatment is available. In the present study, we used joint distraction, a relatively new treatment in which mechanical contact between the articular surfaces is avoided while intraarticular intermittent fluid pressure is maintained, to treat patients with severe OA of the ankle.Methods. Patients with severe ankle OA (n ‫؍‬ 57) who were being considered for joint fusion (arthrodesis) were treated with joint distraction in an open prospective study. In addition, a randomized trial was performed in 17 patients to determine whether joint distraction had a better outcome than debridement. A standardized evaluation protocol (physical examination, assessment of pain, mobility, and functional ability) was used, and changes in radiographic joint space width and subchondral sclerosis were measured. Thirtyeight patients in the open study have been followed up for >1 year, with up to 5 years of followup in 7 of them (mean ؎ SD followup 2.8 ؎ 0.3 years). Patients in the randomized study have been followed up for 1 year.Results. Significant clinical benefit was found in three-fourths of the 57 patients in the open prospective study. Most interestingly, the improvement increased over time. Radiographic evaluation showed increased joint space width and decreased subchondral sclerosis. Moreover, joint distraction showed significantly better results than debridement.Conclusion. The clinical benefit of joint distraction in the treatment of severe OA is proof of the concept. Although the followup remains relatively short and effects over time remain unpredictable, our study creates possibilities for the treatment of severe OA in general. Considering the high prevalence of OA and the lack of a cure for it, joint distraction as a treatment of severe OA may have great medical, social, and economic impact.

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Section: Discussionsupporting

confidence: 78%

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study

Marijnissen¹,

Roermund²,

Melkebeek³

et al. 2002

Arthritis & Rheumatism

136

125

View full text Add to dashboard Cite

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“…The same author reported poor or fair results of arthroscopic debridement for ankle arthritis with a 62% satisfaction rate at a mean follow-up of 45 months. 29 Similar results were reported by Martin et al, where 7 out of 8 patients reported poor results after longterm follow-up. 25 Amendola et al reported on 79 consecutive ankle arthroscopies with a minimum 2-year follow-up.…”

Section: Joint-preserving Surgerysupporting

confidence: 84%

Joint Preservation Procedures for Ankle Arthritis

et al. 2013

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Level of Evidence: Level V, expert opinion. A: Good evidence (level I studies with consistent finding) for or against recommending intervention. B: Fair evidence (level II or III studies with consistent findings) for or against recommending intervention. C: Poor-quality evidence (level IV or V) for or against recommending intervention. I: There is insufficient or conflicting evidence not allowing a recommendation for or against intervention. Source: Wright JG, Einhorn TA, Heckman JD. Grades of recommendation.

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“…The authors divided malunions above the ankle joint in 2 main groups: following the bimalleolar fracture (Pott's type) and following the trimalleolar fracture (Cotton's type). The authors identified 3 crucial aims of supramalleolar realignment [7] b (eg, before the application of external fixator in the same surgical setting (one-stage procedure) to remove inflamed synovium, unstable cartilage, loose bodies, fibrotic tissue, osteophytes causing impingement [7] c Debridement of fibrotic tissue and impinging osteophytes in ord e r t o i m p r o v e t h e an k l e dorsiflexion [9] Procedure Indications Joint-preserving procedures Arthroscopy/arthrotomy debridement [6,7] • Ankle symptoms from specific joint conditions a • Anterior ankle impingement • Early-stage ankle osteoarthritis with intact joint space a • Posterior tibial osteophytes; posterior impingement symptoms…”

Section: Historical Perspective On Supramalleolar Osteotomymentioning

confidence: 99%

Single-Stage Supramalleolar Osteotomy for Coronal Plane Deformity

Barg

Saltzman

2014

Curr Rev Musculoskelet Med

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A variety of surgical procedures are utilized for management of ankle osteoarthritis. The most common etiology in patients with ankle osteoarthritis is post-traumatic often resulting in asymmetric ankle osteoarthritis with concomitant valgus or varus deformity. A substantial part of tibiotalar joint is often preserved, therefore, in appropriate patients, jointpreserving surgery holds the potential to be a superior treatment option than joint-sacrificing procedures including total ankle replacement or ankle arthrodesis. This review is designed to describe indications and contraindications for single-stage supramalleolar realignment surgery. Complications associated with this type of surgery and postoperative outcome are highlighted using recent literature.

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Arthroscopic debridement for the osteoarthritic ankle

Cited by 58 publications

References 14 publications

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study

Joint Preservation Procedures for Ankle Arthritis

Single-Stage Supramalleolar Osteotomy for Coronal Plane Deformity

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