Tibiotalocalcaneal arthrodesis using a humeral locking plate

Dugiełło

The Journal of Foot and Ankle Surgery

et al. 2022

BackgroundTibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities. Material and methodsThe study group consisted of 19 men who were subjected to intramedullary and intra-osseous arthrodesis using an intramedullary nail. The average age of patients was 46 years (19-68). The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group of patients, clinical condition was assessed using the AOFAS classi cation, quality of life using the SF-12 scale, and assessment of pain intensity using the VAS scale. The above parameters were evaluated before surgery in the early (under 2 years), intermediate (from 2-5 years) and late (over 5 years) postoperative period. ResultsAnalysis of the results showed that the assessed clinical condition on the AOFAS scale improved from an average of 20.6 points before TTCA to 63.5 points after the procedure. The result was statistically signi cant (p < 0.0001). Analyzing the results obtained using the SF-12 quality of life scale, a statistically signi cant increase was found. In the physical sphere of quality of life PCS-12 increased from 26.5 points to 44.2 points (p = 0.0004) and in the mental sphere of quality of life MCS-12 from 46.1 points to 52.6 points (p = 0.030). The intensity of pain ailments, assessed in the VAS scale, decreased in all three periods of postoperative observation (in the early period p < 0.05, in the intermediate period p = 0.23, and in the late period p < 0.05), with the strongest analgesic effect (reduction of pain intensity by 4.3 points on the VAS scale) was observed in the early post-operative follow-up period. ConclusionsTibiotalocalcaneal arthrodesis using an intramedullary nail causes a signi cant improvement in the clinical condition according to the AOFAS classi cation, enabling most patients to move independently, a signi cant improvement in the physical and mental quality of life assessed in the SF-12 scale and a signi cant reduction in the intensity of pain ailments assessed in the VAS scale, especially in the early postoperative period.

Section: Discussionmentioning

confidence: 97%

Tibiotalocalcaneal Arthrodesis in Osteoarthritis Deformation of Ankle and Subtalar Joint: Evaluation of Treatment Results

Dugiełło

The Journal of Foot and Ankle Surgery

et al. 2022

“…In both later observation periods, the reduction in pain intensity had lower VAS scores. It seems that the reduction in the severity of pain may have been due to a change in biomechanics of the foot.Lee et al, in a comparable group of patients who had tibiotalocalcaneal arthrodesis using an intramedullary nail during the observation period of 13-49 months, found a significant reduction in pain intensity on the VAS scale with an average of 7.41 ± 2.12 points up to 1.77 ± 2.77[10].In turn, Cabrera Mendez et al, in a group of 28 men with post-traumatic degenerative changes caused by gunshot injuries of the lower leg operated on with the use of a proximal shoulder plate for tibiotalocalcaneal arthrodesis, found a significant decrease in the intensity of pain, on average from 8.0 to 2.35 points on the VAS scale, over a minimum of 6 months follow-up[20].By contrast, Brodsky et. al., in patients operated using pantalar arthrodesis using an intramedullary nail, observed a significant reduction of pain in the VAS scale before surgery from 6.5 to 1.3 in a follow-up period of over 2 years (26 months).…”

mentioning

confidence: 94%

Tibiotalocalcaneal arthrodesis in osteoarthritis deformation of ankle and subtalar joint – evaluation of treatment results

Dugiełło

et al. 2020

Preprint

Background Tibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities. Material and methods The study group consisted of 19 men who were subjected to intramedullary and intra-osseous arthrodesis using an intramedullary nail. The average age of patients was 46 years (19–68). The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group of patients, clinical condition was assessed using the AOFAS classification, quality of life using the SF-12 scale, and assessment of pain intensity using the VAS scale. The above parameters were evaluated before surgery in the early (under 2 years), intermediate (from 2–5 years) and late (over 5 years) postoperative period. Results Analysis of the results showed that the assessed clinical condition on the AOFAS scale improved from an average of 20.6 points before TTCA to 63.5 points after the procedure. The result was statistically significant (p < 0.0001). Analyzing the results obtained using the SF-12 quality of life scale, a statistically significant increase was found. In the physical sphere of quality of life PCS-12 increased from 26.5 points to 44.2 points (p = 0.0004) and in the mental sphere of quality of life MCS-12 from 46.1 points to 52.6 points (p = 0.030). The intensity of pain ailments, assessed in the VAS scale, decreased in all three periods of postoperative observation (in the early period p < 0.05, in the intermediate period p = 0.23, and in the late period p < 0.05), with the strongest analgesic effect (reduction of pain intensity by 4.3 points on the VAS scale) was observed in the early post-operative follow-up period. Conclusions Tibiotalocalcaneal arthrodesis using an intramedullary nail causes a significant improvement in the clinical condition according to the AOFAS classification, enabling most patients to move independently, a significant improvement in the physical and mental quality of life assessed in the SF-12 scale and a significant reduction in the intensity of pain ailments assessed in the VAS scale, especially in the early postoperative period.

“…Lee et al, in a comparable group of patients who had tibiotalocalcaneal arthrodesis using an intramedullary nail during the observation period of 13-49 months, found a signi cant reduction in pain intensity on the VAS scale with an average of 7.41 ± 2.12 points up to 1.77 ± 2.77[10].In turn, Cabrera Mendez et al, in a group of 28 men with post-traumatic degenerative changes caused by gunshot injuries of the lower leg operated on with the use of a proximal shoulder plate for tibiotalocalcaneal arthrodesis, found a signi cant decrease in the intensity of pain, on average from 8.0 to 2.35 points on the VAS scale, over a minimum of 6 months follow-up[20].…”

mentioning

confidence: 95%

Tibiotalocalcaneal arthrodesis in osteoarthritis deformation of ankle and subtalar joint – evaluation of treatment results

Dugiełło²,

et al. 2020

Preprint

Background Tibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities. Methods The study group consisted of 19 men who were subjected to intramedullary and intra-osseous arthrodesis using an intramedullary nail. The average age of patients was 46 years (19–68). The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group of patients, clinical condition was assessed using the AOFAS classification, quality of life using the SF-12 scale, and assessment of pain intensity using the VAS scale. The above parameters were evaluated before surgery in the early (under 2 years), intermediate (from 2–5 years) and late (over 5 years) postoperative period. Results Analysis of the results showed that the assessed clinical condition on the AOFAS scale improved from an average of 20.6 points before TTCA to 63.5 points after the procedure. The result was statistically significant (p < 0.0001). Analyzing the results obtained using the SF-12 quality of life scale, a statistically significant increase was found. In the physical sphere of quality of life PCS-12 increased from 26.5 points to 44.2 points (p = 0.0004) and in the mental sphere of quality of life MCS-12 from 46.1 points to 52.6 points (p = 0.030). The intensity of pain ailments, assessed in the VAS scale, decreased in all three periods of postoperative observation (in the early period p < 0.05, in the intermediate period p = 0.23, and in the late period p < 0.05), with the strongest analgesic effect (reduction of pain intensity by 4.3 points on the VAS scale) was observed in the early post-operative follow-up period. Conclusions Tibiotalocalcaneal arthrodesis using an intramedullary nail causes a significant improvement in the clinical condition according to the AOFAS classification, enabling most patients to move independently, a significant improvement in the physical and mental quality of life assessed in the SF-12 scale and a significant reduction in the intensity of pain ailments assessed in the VAS scale, especially in the early postoperative period.