Outcomes of Ankle Arthrodesis Conversion to Total Ankle Arthroplasty: A Systematic Review

Chu, Anson K.; Wilson, Matthew D.; Houng, Brian E.; Thompson, John M.; So, Eric

doi:10.1053/j.jfas.2020.06.025

Cited by 12 publications

(10 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the final stage, the surgical treatment of OA, until recently, as a gold standard, was based on pain control at the expense of mobility and joint preservation through arthrodesis (3,8) . This treatment was associated with a high rate of arthrosis in adjacent joints in the medium and long-term, especially in the hindfoot (4,12) , requiring additional surgical procedures and decreasing patient satisfaction (2) .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ankle desarthrodesis: report of three cases

et al. 2022

View full text Add to dashboard Cite

The good results of primary ankle arthroplasty and long-term dissatisfaction with arthrodesis have made arthrodesis, that is, the conversion of an arthrodesis into arthroplasty, an option for patients with a painful ankle fusion. This study presents the results of three patients submitted to ankle desarthrodesis in Brazil between 2019 and 2021. Two men and one woman, aged between 48 and 52 years and with an arthrodesis prosthetic interval between two and 30 years, presented satisfactory results after arthroplasty. Pain reduction and increased functional capacity were observed, representing an improvement in the visual analog scale (VAS) between 5 and 6 points, range of motion (ROM) gain between 20Åã and 45Åã and progress in the American Orthopaedic Foot & Ankle Society (AOFAS) score between 17 and 54 points in the postoperative follow-up. Although it is a procedure with a long learning curve, desarthrodesis should be considered a therapeutic alternative to painful ankle arthrodesis. Level of Evidence IV; Case Series; Therapeutic Studies - investigating the results of treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Unlike the large joints of the lower limb, where the primary origin is the main etiology (3) , the ankle is predominantly post-traumatic (78%), followed by other systemic secondary causes (13%), such as rheumatoid arthritis and hemophilia. The primary etiology is rare and represents only 9% of the cases (4,5) .…”

Section: Introductionmentioning

confidence: 99%

Ankle desarthrodesis: report of three cases

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Patients overall respond well to the revision TAA, over that of previously favored revision fusion, and it may be a promising salvage method. 18…”

Section: Arthrodesismentioning

confidence: 99%

Postoperative Ankle Imaging, 2022

Shrestha

Sill

Haug

et al. 2022

Semin Musculoskelet Radiol

View full text Add to dashboard Cite

Postoperative ankle imaging requires knowledge of the underlying surgical techniques, the usefulness of various imaging modalities, as well as an appreciation for the desired clinical outcomes. Surgical procedures discussed in this article are tibiotalar fracture fixation, tibiotalar, subtalar, and tibiotalocalcaneal arthrodesis, total ankle arthroplasty, talar osteochondral lesion repair and grafting, lateral ligamentous repair and reconstruction, and peroneal and Achilles tendon repair and reconstruction. Imaging can play a vital role in determining if the expected outcome has been achieved and identifying complications, with particular emphasis placed on the use of radiographs, computed tomography (including weight-bearing), magnetic resonance imaging, and ultrasonography.

show abstract

“…TXA was also associated with a trend toward reduction in nonunion from 23.0% to 19.0%, which is similar to reported rates of nonunion for ankle fusions at 23% by other authors. 28 The mechanism underlying the decreased time to fusion in the ankle/hindfoot fusion cohort that received TXA may be related to either TXA's immunomodulatory effects or hemostasis, as discussed later. To the best of our knowledge, this is the first study investigating the effect of TXA on the outcomes of hindfoot and ankle fusions.…”

Section: Figurementioning

confidence: 99%

Tranexamic Acid Associated With Less Wound Complications in Ankle and Hindfoot Surgery

Moore

Smith

O'Leary

et al. 2022

J Am Acad Orthop Surg

View full text Add to dashboard Cite

Introduction:The purpose of this study was to determine whether total ankle arthroplasty (TAA) and ankle/hindfoot fusion patients receiving tranexamic acid (TXA) exhibit fewer wound complications.Methods:A retrospective review was conducted of 212 patients (217 feet) undergoing TAA (n = 72), ankle (n = 36), tibiotalocalcaneal (n = 20), pantalar (n = 1), or hindfoot fusion (ie, subtalar = 47, double = 33, and triple = 8) between 2015 and 2020 by a fellowship-trained foot and ankle surgeon at an academic medical center. Demographics, medical history, complications, and union status were compared between TXA (n = 101) and non-TXA (n = 116) cohorts. The mean follow-up was 1.24 years (range, 0.25 to 4.68).Results:The TXA group had significantly less postoperative infections (5.9% versus 15.5%, P = 0.025). Within a subgroup analysis of ankle/hindfoot fusions, the TXA group exhibited significantly more Charcot neuroarthropathy (20.7% versus 5.7%, P = 0.006) and shorter follow-up duration (0.96 versus 1.30 years, P = 0.030); however, TXA was associated with shorter time to fusion (146 versus 202 days, P = 0.049) and fewer revision surgeries (8.6% versus 21.8%, P = 0.036). Subgroup analysis excluding feet with Charcot also demonstrated less postoperative infections (4.5% versus 14.4%, P = 0.020). Subgroup analysis of TAAs showed fewer cases of superficial infections (2.3% versus 27.6%, P = 0.002) and delayed wound healing (25.6% versus 48.3%, P = 0.047) in the TXA cohort.Discussion:TXA use in ankle/hindfoot surgery was correlated with a reduction in superficial infections and radiographic time to union. The use of TXA in TAA correlated with fewer superficial infections and cases of delayed wound healing. Thus, in addition to other areas of orthopaedics, TXA seems to be beneficial in hindfoot and ankle surgery.Data availability and trial registration numbers:All data were obtained from our institution's medical records. This study is not associated with a clinical trial.

show abstract

Outcomes of Ankle Arthrodesis Conversion to Total Ankle Arthroplasty: A Systematic Review

Cited by 12 publications

References 37 publications

Ankle desarthrodesis: report of three cases

Ankle desarthrodesis: report of three cases

Postoperative Ankle Imaging, 2022

Tranexamic Acid Associated With Less Wound Complications in Ankle and Hindfoot Surgery

Contact Info

Product

Resources

About