Patient reported outcome measures in ankle replacement versus ankle arthrodesis – A systematic review

Gajebasia, Sarveen; Jennison, Toby; Blackstone, James; Zaidi, Razi; Müller, Patrick; Goldberg, Andy

doi:10.1016/j.foot.2021.101874

Cited by 8 publications

(7 citation statements)

References 43 publications

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“…There is still no consensus on the difference in outcomes following these alternative procedures. 6 A concern with an ankle arthrodesis is the potential development of adjacent joint arthritis requiring surgery, and this has been shown to be lower in ankle replacements. 5,14 This study demonstrates that those that then develop subtalar arthritis and require a subtalar arthrodesis have significantly higher rates of nonunion than those with a native joint.…”

Section: Discussionmentioning

confidence: 99%

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Subtalar Arthrodesis Union Rates With and Without Adjacent Ankle Arthrodesis

et al. 2022

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Background: Subtalar arthrodesis is the surgical procedure commonly performed to treat subtalar arthritis. Subtalar arthrodesis may have a higher nonunion rate if there is a preexisting adjacent joint arthrodesis. The aim of this retrospective cohort study was to compare the subtalar arthrodesis union rate of patients with native tibiotalar joints to that of patients with prior tibiotalar arthrodesis. The secondary aim was to assess risk factors for nonunion. Methods: A retrospective cohort study of consecutive patients that underwent a subtalar arthrodesis in a single center between 2010 and 2020. The primary outcome of union was determined based on bridging callus on radiographs and clinical symptoms. If there was uncertainty, then a nonweightbearing CT was acquired. Chi-squared test and Mann-Whitney tests compared differences in demographics and risk factors for nonunion between groups. A logistical regression model was performed to determine risk factors for nonunion. Results: Eighteen patients had an adjacent ankle arthrodesis and 53 patients did not. The successful subtalar arthrodesis union rate in those with a preexisting ankle joint arthrodesis (44.4%) was approximately half that in those without an ankle joint arthrodesis (86.8%) ( P < .001). On multivariate logistic regression, an adjacent ankle arthrodesis was the only significant risk factor for nonunion. The odds ratio of nonunion of the subtalar joint with an adjacent ankle arthrodesis present was 4.90 (95% CI 1.02-23.56) compared to a subtalar arthrodesis with a native ankle joint. In addition, 9.4% of patients without an ankle arthrodesis underwent a revision subtalar arthrodesis compared with 44.4% of those with an adjacent ankle arthrodesis ( P = .001). Conclusion: In our study, we found that patients undergoing a subtalar arthrodesis with an adjacent ankle arthrodesis have a significantly increased risk of nonunion compared with those undergoing a subtalar arthrodesis with a native ankle. Patients with a previously fused ankle need counseling about the high risk of nonunion and potential additional surgery.

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Section: Discussionmentioning

confidence: 99%

“…The surgical treatment of end-stage ankle arthritis includes ankle arthrodesis or ankle replacement. 6 Both have demonstrated improved functional outcomes. It is thought there may be an increased risk of developing adjacent joint arthritis following an ankle arthrodesis.…”

Section: Introductionmentioning

confidence: 99%

Subtalar Arthrodesis Union Rates With and Without Adjacent Ankle Arthrodesis

et al. 2022

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“…9,18,19,38 Ankle replacements potentially result in improved functional outcomes, but failure rates higher than those of other joint arthroplasty have been reported. 5,20,24,33,47 There remains debate about which patients should undergo an ankle replacement rather than fusion. 20,21,22 In the hip and knee arthroplasty literature the patient factors that determine the survival, such as age, body mass index (BMI), gender, etiology of arthritis, and comorbidities, have been explored, but their effect on the outcome of ankle replacements remains unknown.…”

Section: Introductionmentioning

confidence: 99%

“…5,20,24,33,47 There remains debate about which patients should undergo an ankle replacement rather than fusion. 20,21,22 In the hip and knee arthroplasty literature the patient factors that determine the survival, such as age, body mass index (BMI), gender, etiology of arthritis, and comorbidities, have been explored, but their effect on the outcome of ankle replacements remains unknown. 1,16,28,29,48,50 The primary aim of this study is to analyze the risk factors for failure of total ankle replacements.…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Failure of Total Ankle Replacements: A Data Linkage Study Using the National Joint Registry and NHS Digital

et al. 2023

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Background: Despite the increasing numbers of ankle replacements, there remains debate about which patients should undergo an ankle replacement, and there are limited studies analyzing risk factors for failure of an ankle replacement. The primary aim of this study is to analyze the risk factors for failure of total ankle replacements. Methods: A data linkage study combining the National Joint Registry (NJR) Data and NHS (National Health Service) Digital data was performed. The primary outcome of failure is defined as the removal or exchange of any components of the implanted device. Kaplan-Meier survival charts were used to illustrate survivorship. Multivariable Cox proportional hazards regression models were fitted to analyze potential risk factors for failures or ankle replacements. Results: The overall 5-year survival was 90.2% (95% CI 89.2%-91.1%). In multivariable (adjusted) Cox regression models, only age (hazard ratio [HR] 0.96, 95% CI 0.94-0.97), body mass index (BMI; HR 1.03, 95% CI 1.01-1.06), and underlying etiology (HR 0.88, 95% CI 0.80-0.97) were associated with an increased risk of failure. Conclusion: This study demonstrates that younger patients and those with an increased BMI have an increased risk of failure of a primary ankle replacement. We also show that rheumatoid patients have higher survivorship than those with osteoarthritis. Level of Evidence: Level III, retrospective cohort study.

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Surgical Technique and Postoperative Care

Hintermann,

Ruiz

2024

Total Ankle Replacement

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Patient reported outcome measures in ankle replacement versus ankle arthrodesis – A systematic review

Cited by 8 publications

References 43 publications

Subtalar Arthrodesis Union Rates With and Without Adjacent Ankle Arthrodesis

Subtalar Arthrodesis Union Rates With and Without Adjacent Ankle Arthrodesis

Risk Factors for Failure of Total Ankle Replacements: A Data Linkage Study Using the National Joint Registry and NHS Digital

Surgical Technique and Postoperative Care

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