Comparison of Health-Related Quality of Life Between Patients with End-Stage Ankle and Hip Arthrosis

Glazebrook, Mark; Daniels, Tim R.; Younger, Alastair; Foote, Clary J; Penner, Murray; Wing, Kevin; Lau, Johnny; Leighton, Ross; Dunbar, Michael J.

doi:10.2106/jbjs.f.01299

Cited by 430 publications

(287 citation statements)

References 20 publications

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“…Glazebrook et al [10] reported that the mental and physical disabilities caused by end-stage ankle arthritis were at least as severe as those observed in patients with end-stage hip arthritis. Patients with ankle arthritis often present with concomitant hindfoot deformity, which may involve the tibiotalar and subtalar joints [16].…”

Section: Introductionmentioning

confidence: 99%

Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Wang

Saltzman

Chalayon

et al. 2015

Clinical Orthopaedics &Amp; Related Research

106

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Background Patients with ankle arthritis often present with concomitant hindfoot deformity, which may involve the tibiotalar and subtalar joints. However, the possible compensatory mechanisms of these two mechanically linked joints are not well known. Questions/purposes In this study we sought to (1) compare ankle and hindfoot alignment of our study cohort with end-stage ankle arthritis with that of a control group; (2) explore the frequency of compensated malalignment between the tibiotalar and subtalar joints in our study cohort; and (3) assess the intraobserver and interobserver reliability of classification methods of hindfoot alignment used in this study. Methods Between March 2006 and September 2013, we performed 419 ankle arthrodesis and ankle replacements (380 patients). In this study, we evaluated radiographs for 233 (56%) ankles (226 patients) which met the following inclusion criteria: (1) no prior subtalar arthrodesis; (2) no previously failed total ankle replacement or ankle arthrodesis; (3) with complete conventional radiographs (all three ankle views were required: mortise, lateral, and hindfoot alignment view). Ankle and hindfoot alignment was assessed by measurement of the medial distal tibial angle, tibial talar surface angle, talar tilting angle, tibiocalcaneal axis angle, and moment arm of calcaneus. The obtained values were compared with those observed in the control group of 60 ankles from 60 people. Only those without obvious degenerative changes of the tibiotalar and subtalar joints and without previous surgeries of the ankle or hindfoot were included in the control group. Demographic data for the patients with arthritis and the control group were comparable (sex, p = 0.321; age, p = 0.087). The frequency of compensated malalignment between the tibiotalar and subtalar joints, defined as tibiocalcaneal angle or moment arm of the calcaneus being greater or smaller than the same 95% CI statistical cutoffs from the control group, was tallied. All ankle radiographs were independently measured by two observers to determine the interobserver reliability. One of Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangement etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. This ...

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Section: Introductionmentioning

confidence: 99%

Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Wang

Saltzman

Chalayon

et al. 2015

Clinical Orthopaedics &Amp; Related Research

106

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“…The physical and mental impairments for patients with ankle arthritis are equivalent to that of hip arthritis and other severely disabling medical problems [10,21,23]. Patients for whom nonoperative management fails may be offered surgery.…”

Section: Introductionmentioning

confidence: 99%

“…The effectiveness of each procedure or health state is measured in utility units that incorporate subjective measures of wellness or quality of life [11]. Each health state in the model is assigned a utility value along a continuum of 1.0 equaling perfect health and 0.0 equaling death based on quality of wellbeing index scores [9,10,23,24,26]. The utility for each health state then is multiplied by the number of years a patient experiences that health state and is reported in QALY.…”

Section: Introductionmentioning

confidence: 99%

Is Total Ankle Arthroplasty A Cost-effective Alternative to Ankle Fusion?

Courville

Hecht

Tosteson

2011

Clinical Orthopaedics &Amp; Related Research

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Background Total ankle arthroplasty (TAA) implantation is increasing, as the potential for pain relief and restoration of function and risks are compared with those for ankle fusion. A previous analysis with a simple decision tree suggested TAA was cost-effective compared with ankle fusion. However, reevaluation is warranted with the availability of newer, more costly implants and longer-term patient followup data. Questions/purposes Considering all direct medical costs regardless of the payer, we determined if TAA remains a cost-effective alternative to ankle fusion when updated evidence is considered. Patients and Methods Using a Markov model, we evaluated expected costs and quality-adjusted life years (QALY) for a 60-year-old hypothetical cohort with endstage ankle arthritis treated with either TAA or ankle fusion. Costs were estimated from 2007 diagnosis-related group (DRG) and current procedural terminology (CPT) codes for each procedure. Rates were extracted from the literature. The incremental cost-effectiveness ratio (ICER), a measure of added cost divided by QALY gained for TAA relative to ankle fusion, was estimated. To identify factors affecting the value of TAA, sensitivity analyses were performed on all variables.

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“…Patients with end-stage osteoarthritis have a loss of cartilage and mechanoreceptors, joint laxity, and significant inflammation resulting in reduced proprioception and postural balance feedback [3,4].…”

mentioning

confidence: 99%

Unipedal Balance Is Affected by Lower Extremity Joint Arthroplasty Procedure 1 Year Following Surgery

Butler¹,

Thiele

Barnes

et al. 2015

The Journal of Arthroplasty

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Comparison of Health-Related Quality of Life Between Patients with End-Stage Ankle and Hip Arthrosis

Abstract: The mental and physical disability associated with end-stage ankle arthrosis is at least as severe as that associated with end-stage hip arthrosis.

Cited by 430 publications

References 20 publications

Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Does the Subtalar Joint Compensate for Ankle Malalignment in End-stage Ankle Arthritis?

Is Total Ankle Arthroplasty A Cost-effective Alternative to Ankle Fusion?

Unipedal Balance Is Affected by Lower Extremity Joint Arthroplasty Procedure 1 Year Following Surgery

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