Outcome After Single Technique Ankle Arthrodesis in Patients With Rheumatoid Arthritis

Abstract

The established treatment for severe rheumatoid arthritis in the ankle is arthrodesis. Numerous reports in the literature describe outcomes in patients with degenerative and posttraumatic arthrosis and rheumatoid disease. This has led to results that are difficult to interpret. In addition, in the few studies that have evaluated patients with rheumatoid disease many techniques of arthrodesis are reported, further confounding assessment of one fusion method. One technique of 20 ankle fusions in patients with rheumatoid disease was evaluated. A modified Wagner arthrodesis was used through a transfibular approach using parallel compression screws. The scoring systems of Mazur et al, Moran et al, and the Short-Form-36 were used to evaluate the outcome. The mean time to followup was 3 years 10 months. Eighteen of 20 fusions obtained a solid talocrural union (90%). No correlation was found between the scores of Mazur et al and Moran et al. Correlation was achieved between the scores for the Short Form-36 and Moran et al. The modified Wagner ankle arthrodesis is a simple, reliable, reproducible technique with a 90% union rate. The value of the technique has been confirmed in patients with rheumatoid arthritis by evaluating the outcome using a scoring system that is validated and relevant to this population.

Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach

“…The two groups had similar demographics, time of onset of symptoms, and preoperative outcome scores. While not designed as specific scores for the hindfoot, the AOFAS hindfoot and the SF-36 scores have been used previously for this purpose [10].…”

“…The AOFAS ankle-hindfoot score evaluates pain (40 points), function (50 points), and alignment (10 points). The SF-36v2 is a general health survey with physical and mental components and has been validated internally and externally in foot and ankle hindfoot surgery [10,22].…”

Anterior ankle arthrodesis

“…Techniques of internal and external fixation have been reported with varying degrees of success [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . The outcomes of intramedullary rodding, a common alternative to pantalar arthrodesis with plating, have often been reported in the literature.…”

The mid-term outcome of total ankle arthroplasty and ankle fusion in rheumatoid arthritis: a systematic review

“…However this review revealed the methodological quality of included studies no certain cut-off value was applied as exclusion criterion regarding the small number of studies (17). Statistical parameters as the standard deviation, which was absent in 4 studies [ 19 , 21 , 23 , 24 , 26 ] prevented measuring the effect size.…”