Subtalar arthrosis following ankle arthrodesis

Leicht, P.; Kofoed, Hakon

doi:10.1016/0958-2592(92)90024-j

Cited by 17 publications

(3 citation statements)

References 9 publications

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“…14, 15 The results of previous studies on ankle arthrodesis have been very variable. [16][17][18][19][20][21] Rheumatoid arthritis seems to have the worst outcome after this procedure, 21,22 but OA also has a high failure rate of about 20% nonunion and about 15% deep infection.…”

Section: Discussionmentioning

confidence: 92%

Ankle arthroplasty for rheumatoid arthritis and osteoarthritis

Kofoed

Sôrensen

1998

The Journal of Bone and Joint Surgery. British volume

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We performed 52 cemented ankle arthroplasties for painful osteoarthritis (OA) (25) or rheumatoid arthritis (RA) (27) using an ankle prosthesis with a near-anatomical design.We assessed the patients radiologically and clinically for up to 14 years using an ankle scoring system. The preoperative median scores were 29 for the OA group and 25 for the RA group and at ten years were 93.5 and 83, respectively. Six ankles in the OA group and five in the RA group required revision or arthrodesis.Survivorship analysis of the two groups showed no significant differences with 72.7% survival for the OA group and 75.5% for the RA group at 14 years.J Bone Joint Surg [Br] 1998;80-B:328-32. Received 4 August 1997; Accepted after revision 31 October 1997There has been only one study of more than 50 cases which has reported the long-term results of cemented ankle arthroplasty over ten years.1 No difference was found between patients with OA and RA, which is contrary to results from smaller series of other first-generation constrained prostheses 2-5 in which true comparisons were not made. The estimated survival rate of the arthroplasty was 61% at 15 years, and further use of the prosthesis was abandoned although pain or function were not analysed. We describe a prospective study over 14 years of patients with OA and RA which analyses the clinical and radiological differences between the groups and the long-term survivorship of the prosthesis.

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Section: Discussionmentioning

confidence: 92%

Ankle arthroplasty for rheumatoid arthritis and osteoarthritis

Kofoed

Sôrensen

1998

The Journal of Bone and Joint Surgery. British volume

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“…However, this is in contrast to the results of ankle arthrodesis, where development of subtalar arthrosis is a common finding. 4,5,[14][15][16] Age did not influence the results at this point in followup. No correlation was observed between the age of the patients and obtained functional result, pain, ROM, and periarticular ossifications.…”

Section: Discussionmentioning

confidence: 49%

Scandinavian Total Ankle Replacement

Valderrábano

Hintermann

Dick

2004

Clinical Orthopaedics &Amp; Related Research

253

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The purpose of the current prospective study was to determine the midterm results of 68 total ankle replacements with the Scandinavian Total Ankle Replacement (S.T.A.R.) prosthesis. The 65 patients (34 women and 31 men; mean age at surgery, 56.1 years [range, 22-85 years]) were assessed clinically and radiologically after 3.7 years (range, 2.4-6.2 years). Thirty-five patients (54%) were totally pain-free. The overall clinical score was graded as excellent or good in 67 ankles. The American Orthopaedic Foot and Ankle Society hindfoot score improved from 24.7 points (range, 3-44 points) preoperatively to 84.3 points (range, 44-100 points) at followup. Three patients (three ankles, 4.4%) had a ballooning bone lysis on the tibial side. Despite prophylaxis, periarticular hypertrophic bone formation was seen in 43 ankles (63%; 42 patients), associated with a decrease of dorsiflexion and plantar flexion. Nine ankles (13%; nine patients) had revision surgery because of problems with the components and 14 ankles (21%; 14 patients) had secondary or additional operations. All revision or secondary surgeries were successful, and no ankle had to be converted to an ankle arthrodesis. The early experience with the S.T.A.R. ankle implant is encouraging, although we have encountered more complications and potential problems than previously reported.Although numerous studies have shown encouraging short-term results of total ankle arthroplasty, 6,13,17,21 medium-term and long-term results have revealed considerable complications, including ankle pain, painful malleolar impingement, tibial component loosening, and talar component subsidence. 2,7,18,20,22,23,25 The length of followup was a major factor in relation to patient satisfaction, with patients with longer followup generally having declining degrees of satisfaction. The major factors implicated in loosening were highly constrained designs and cement fixation. 4,9 More recent approaches to total ankle replacement have emerged to permit semiconstrained to nonconstrained motion, and to rely on bone ingrowth for implant stability. Among others, the cementless, three-component S.T.A.R. (LINK S.T.A.R. Scandinavian Total Ankle Replacement, Waldemar Link, Hamburg, Germany) prosthesis has become popular. For the cementless S.T.A.R. prosthesis, to our knowledge, only two studies have provided outcomes in the peer reviewed literature. Kofoed and Danborg 11 reported very encouraging results in 31 in patients with osteoarthritis (OA), who were followed up for 3.5 years (range, 1-8 years). In this series, there was one revision done for malalignment. All patients were reported to be improved clinically as a result of the operation, and none had evidence of component loosening or subsidence. In seven ankles treated in patients with rheumatoid arthritis (RA), Wood et al 24 reported good function and range of motion (ROM) for maximal dorsiflexion to maximal plantar flexion of 30°after 5.4 years (range, 5-6 years). None of the seven ankles had any progressive lucency.The purpose of the curren...

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“…Here, the complication rate cited in serious follow-up studies covering a period of 5 years or more is almost 50% [18,20,28] and also involves the need for additional arthrodeses. This is exacerbated by the fact that, even during the first 6 years following a successfully und correctly implemented arthrodesis of the upper ankle, many patients experience persistent symptoms, while some feel very handicapped even when walking on flat ground.…”

Section: Discussionmentioning

confidence: 99%

Prosthetic Replacement of the Ankle in Posttraumatic Arthrosis 10-Year Experience with the Cementless ESKA Ankle Prosthesis

Rudigier¹,

Gründei²,

Menzinger

2001

Eur J Trauma

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Background: As a result of numerous failed implantations of cemented ankle prostheses since the early 70s, ankle arthrodesis represented the "gold standard" in the treatment of ankle arthrosis. Due to a change to cementless implantations in the 90s it came to a remarkable reduction in early loosening, bone necrosis and sintering of the prosthesis which were the main reasons for former failures. In cooperation with ESKA Implants, Lübeck, we have developed a cementless anatomic ankle prosthesis. Patients and Methods: At our hospital, the ESKA prosthesis has been implanted in 56 patients (72% posttraumatic) since 1990. In our study, we report the examination results of 40 out of these 56 patients at least 1 year post implantation (21 of them more than 5 years). For evaluation, we used the Kofoed ankle score, which allows an easier comparison with other studies. This score showed an average improvement from 34.75 points preoperatively to 91.25 points postoperatively. Results: The persistent preoperative pain had completely disappeared in all patients; only twelve patients complained of intermittent pain under fairly heavy loading. 23 patients were able to walk > 2 km and 13 > 5 km without pain. The overall range of motion was 40-60° in 14 patients, 25-40° in 21, and < 25° in only five. We did not see any kind of secondary arthrosis in the adjacent joints. An arthrodesis which posed no problems had to be performed only three times: in two cases in 1991, during the 1st postoperative year, with both patients showing infections of the prosthesis; in the third case, the prosthesis had to be changed after 9 years.Conclusions: According to our good results and those of other studies on cementless ankle prostheses, we consider a cementless upper ankle prosthesis, implanted by a highly experienced surgeon, the preferable alternative to upper ankle arthrodesis.

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Subtalar arthrosis following ankle arthrodesis

Cited by 17 publications

References 9 publications

Ankle arthroplasty for rheumatoid arthritis and osteoarthritis

Ankle arthroplasty for rheumatoid arthritis and osteoarthritis

Scandinavian Total Ankle Replacement

Prosthetic Replacement of the Ankle in Posttraumatic Arthrosis 10-Year Experience with the Cementless ESKA Ankle Prosthesis

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