Total Ankle Replacement and Simultaneous Subtalar Arthrodesis

Category: Ankle Arthritis Introduction/Purpose: Patients with arthritis or severe malfunctions involving both the ankle and the subtalar joints can benefit tibiotalocalcaneal (TTC) arthrodesis or total ankle replacement and subtalar fusion. Actually, TTC fusion is considered as a salvage option resu...

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Main Authors: Federico G. Usuelli MD, Luigi Manzi MD, Camilla Maccario MD
Format: Article
Language:English
Published: SAGE Publishing 2016-08-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011416S00037
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author Federico G. Usuelli MD
Luigi Manzi MD
Camilla Maccario MD
author_facet Federico G. Usuelli MD
Luigi Manzi MD
Camilla Maccario MD
author_sort Federico G. Usuelli MD
collection DOAJ
description Category: Ankle Arthritis Introduction/Purpose: Patients with arthritis or severe malfunctions involving both the ankle and the subtalar joints can benefit tibiotalocalcaneal (TTC) arthrodesis or total ankle replacement and subtalar fusion. Actually, TTC fusion is considered as a salvage option resulting in a completely stiff ankle and hindfoot, considerably limiting global foot function. With the evolution of prosthetic design and surgical techniques, total ankle replacement (TAR) has become a reasonable alternative to arthrodesis. The aim of this study was to investigate the fusion rate of the subtalar joint in patients simultaneously treated with total ankle replacement (TAR) and subtalar joint fusion. Methods: This study includes 25 patients who underwent primary TAR and simultaneous subtalar fusion from May 2011 to November 2014. Sixteen males (64%) and 9 females (36%) were enroled with a mean age of 58 years (25-82). Patients were clinically assessed preoperatively and at 6 and 12 months postoperatively. Radiographic examination included a postoperative CT scan obtained 12 months after surgery. Results: At 12 months postoperatively, the subtalar fusion rate in patients treated with TAR and simultaneous subtalar fusion was 92%. There was a statistically significant increase in American Orthopedic Foot & Ankle Society ankle/hindfoot score from 27.9 to 75.1. Range of motion significantly increased from 12 to 32.8 degrees. In addition, there was a statistically significant decrease in visual analog scale (VAS) pain score from 8.6 to 2.1. Conclusion: TAR and simultaneous subtalar joint fusion are reliable procedures for the treatment of ankle and subtalar joint arthritis. Furthermore, CT scans showed an excellent reliability among orthopaedic surgeons in determining the degree of successful fusion of subtalar arthrodesis.
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spelling doaj.art-5492f52de6334b75be68ca1c2d8e7fec2022-12-22T00:49:48ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142016-08-01110.1177/2473011416S00037Total Ankle Replacement and Simultaneous Subtalar ArthrodesisFederico G. Usuelli MDLuigi Manzi MDCamilla Maccario MDCategory: Ankle Arthritis Introduction/Purpose: Patients with arthritis or severe malfunctions involving both the ankle and the subtalar joints can benefit tibiotalocalcaneal (TTC) arthrodesis or total ankle replacement and subtalar fusion. Actually, TTC fusion is considered as a salvage option resulting in a completely stiff ankle and hindfoot, considerably limiting global foot function. With the evolution of prosthetic design and surgical techniques, total ankle replacement (TAR) has become a reasonable alternative to arthrodesis. The aim of this study was to investigate the fusion rate of the subtalar joint in patients simultaneously treated with total ankle replacement (TAR) and subtalar joint fusion. Methods: This study includes 25 patients who underwent primary TAR and simultaneous subtalar fusion from May 2011 to November 2014. Sixteen males (64%) and 9 females (36%) were enroled with a mean age of 58 years (25-82). Patients were clinically assessed preoperatively and at 6 and 12 months postoperatively. Radiographic examination included a postoperative CT scan obtained 12 months after surgery. Results: At 12 months postoperatively, the subtalar fusion rate in patients treated with TAR and simultaneous subtalar fusion was 92%. There was a statistically significant increase in American Orthopedic Foot & Ankle Society ankle/hindfoot score from 27.9 to 75.1. Range of motion significantly increased from 12 to 32.8 degrees. In addition, there was a statistically significant decrease in visual analog scale (VAS) pain score from 8.6 to 2.1. Conclusion: TAR and simultaneous subtalar joint fusion are reliable procedures for the treatment of ankle and subtalar joint arthritis. Furthermore, CT scans showed an excellent reliability among orthopaedic surgeons in determining the degree of successful fusion of subtalar arthrodesis.https://doi.org/10.1177/2473011416S00037
spellingShingle Federico G. Usuelli MD
Luigi Manzi MD
Camilla Maccario MD
Total Ankle Replacement and Simultaneous Subtalar Arthrodesis
Foot & Ankle Orthopaedics
title Total Ankle Replacement and Simultaneous Subtalar Arthrodesis
title_full Total Ankle Replacement and Simultaneous Subtalar Arthrodesis
title_fullStr Total Ankle Replacement and Simultaneous Subtalar Arthrodesis
title_full_unstemmed Total Ankle Replacement and Simultaneous Subtalar Arthrodesis
title_short Total Ankle Replacement and Simultaneous Subtalar Arthrodesis
title_sort total ankle replacement and simultaneous subtalar arthrodesis
url https://doi.org/10.1177/2473011416S00037
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AT luigimanzimd totalanklereplacementandsimultaneoussubtalararthrodesis
AT camillamaccariomd totalanklereplacementandsimultaneoussubtalararthrodesis