Performance of Total Ankle Arthroplasty and Ankle Arthrodesis on Uneven Surfaces, Stairs, and Inclines

Jastifer, James R.; Coughlin, Michael J.; Hirose, Christopher B.

doi:10.1177/1071100714549190

Cited by 54 publications

(42 citation statements)

References 33 publications

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“…Similar observations were noted by several other studies examining function and gait of patients after ankle replacement and fusion . In 2015, Jastifer et al stated that while these studies have demonstrated improved gait after both ankle arthroplasty and ankle arthrodesis, neither procedure restores gait to normal. These results prompted us to investigate kinematic mechanisms that may be occurring in adjacent joints and down the kinematic chain which may account for limitations in gait.…”

supporting

confidence: 65%

Distribution of segmental foot kinematics in patients with degenerative joint disease of the ankle

Canseco

Kruger

Fritz

et al. 2017

Journal Orthopaedic Research

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Degenerative joint disease (DJD) of the ankle is a debilitating chronic disease associated with severe pain and dysfunction resulting in antalgic gait alteration. Little information is available about segmental foot and ankle motion distribution during gait in ankle osteoarthritis. The aim of the current study was to dynamically characterize segmental foot and ankle kinematics of patients with severe ankle arthrosis requiring total ankle replacement. This was a prospective study involving 36 (19 M, 17 F) adult patients with a clinical diagnosis of ankle arthrosis ("DJD" group) and 36 (23 M, 13 F) healthy subjects ("Control" group). Motion data were collected at 120 Hz using a 3-D motion camera system at self-selected speed along a 6-m walkway and processed using the Milwaukee Foot Model (MFM). The SF-36 Health Survey and Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale were administered to evaluate functional levels. Findings include decreases in walking speed, cadence, stride length and swing phase, and reduced outcomes scores (SF-36 and AOFAS). Multisegemental motion in patients with ankle DJD demonstrates significant changes in foot mechanics characterized by altered segment kinematics and significant reduction in dynamic ROM at the tibia, hindfoot, forefoot, and hallux when compared to controls. The results demonstrate decreased temporal-spatial parameters and low outcomes scores indicative of functional limitations. Statement of clinical significance: Altered segment kinematics and reduced overall range of motion demonstrate how a single joint pathology affects kinematic distribution in the other segments of the foot and ankle and alters patients' overall gait. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1739-1746, 2018.

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supporting

confidence: 65%

Distribution of segmental foot kinematics in patients with degenerative joint disease of the ankle

Canseco

Kruger

Fritz

et al. 2017

Journal Orthopaedic Research

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“…Two reported no significant difference between the TAA and AA cohorts [20, 22]. The remaining five studies found that patients performed better on gait analysis after TAA [21, 23–25, 29]. Clinical outcomes were collected in six studies [20, 23, 25–28].…”

Section: Resultsmentioning

confidence: 99%

“…The remaining five studies found that patients performed better on gait analysis after TAA [21, 23–25, 29]. Clinical outcomes were collected in six studies [20, 23, 25–28]. Jastifer et al reported improved Beuchel-Pappas scale ( p = 0.036) and AOFAS ( p = 0.03) in the TAA cohort over the AA cohort [23].…”

Section: Resultsmentioning

confidence: 99%

“…Clinical outcomes were collected in six studies [20, 23, 25–28]. Jastifer et al reported improved Beuchel-Pappas scale ( p = 0.036) and AOFAS ( p = 0.03) in the TAA cohort over the AA cohort [23]. Saltzman et al reported significantly greater efficacy ( p < 0.001) and overall success ( p < 0.001) in the Pivotal STAR group over the AA group [26].…”

Section: Resultsmentioning

confidence: 99%

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Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade

et al. 2017

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BackgroundThe surgical treatment of end-stage tibiotalar arthritis continues to be a controversial topic. Advances in surgical technique and implant design have lead to improved outcomes after both ankle arthrodesis (AA) and total ankle arthroplasty (TAA), yet a clear consensus regarding the most ideal form of treatment is lacking. In this study, the outcomes and complications following AA and TAA are compared in order to improve our understanding and decision-making for care and treatment of symptomatic tibiotalar arthritis.MethodsStudies reporting on outcomes and complications following TAA or AA were obtained for review from the PubMed database between January 2006 and July 2016. Results from studies reporting on a minimum of 200 total ankle arthroplasties or a minimum of 80 ankle arthrodesis procedures were reviewed and pooled for analysis. All studies directly comparing outcomes and complications between TAA and AA were also included for review. Only studies including modern third-generation TAA implants approved for use in the USA (HINTEGRA, STAR, Salto, INBONE) were included.ResultsA total of six studies reporting on outcomes following TAA and five reporting on outcomes following AA met inclusion criteria and were included for pooled data analysis. The adjusted overall complication rate was higher for AA (26.9%) compared to TAA (19.7%), with similar findings in the non-revision reoperation rate (12.9% for AA compared to 9.5% for TAA). The adjusted revision reoperation rate for TAA (7.9%) was higher than AA (5.4%). Analysis of results from ten studies directly comparing TAA to AA suggests a more symmetric gait and less impairment on uneven surfaces after TAA.ConclusionsPooled data analysis demonstrated a higher overall complication rate after AA, but a higher reoperation rate for revision after TAA. Based on the existing literature, the decision to proceed with TAA or AA for end-stage ankle arthritis should be made on an individual patient basis.

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“…A study by Jastifer et al evaluated differences between patients who underwent each procedure in terms of their performance on uneven surfaces, stairs, and inclines 16 . The authors found that, although both groups demonstrated improved postoperative performance at the 1-year follow-up, the patients who had undergone TAA had higher scores walking upstairs, downstairs, and uphill.…”

Section: Total Ankle Arthroplastymentioning

confidence: 99%

What’s New in Foot and Ankle Surgery

Yeranosian

2016

The Journal of Bone and Joint Surgery

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Performance of Total Ankle Arthroplasty and Ankle Arthrodesis on Uneven Surfaces, Stairs, and Inclines

Abstract: Level II, prospective cohort study.

Cited by 54 publications

References 33 publications

Distribution of segmental foot kinematics in patients with degenerative joint disease of the ankle

Distribution of segmental foot kinematics in patients with degenerative joint disease of the ankle

Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade

What’s New in Foot and Ankle Surgery

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