Comparison Total Joint Replacement (STAR) with Arthrodesis of the Ankle
Category: Ankle Arthritis Introduction/Purpose: Total joint replacement (TJR) and arthrodesis (A) are treatment options for severe osteoarthritis of the ankle. The aim of this study was to compare outcome (clinical and pedographic) of JTR (STAR, Stryker, Airview Boulevard, MN, USA) and A of the ankl...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2018-09-01
|
| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011418S00403 |
| _version_ | 1819176016113827840 |
|---|---|
| author | Martinus Richter MD, PhD Stefan Zech MD |
| author_facet | Martinus Richter MD, PhD Stefan Zech MD |
| author_sort | Martinus Richter MD, PhD |
| collection | DOAJ |
| description | Category: Ankle Arthritis Introduction/Purpose: Total joint replacement (TJR) and arthrodesis (A) are treatment options for severe osteoarthritis of the ankle. The aim of this study was to compare outcome (clinical and pedographic) of JTR (STAR, Stryker, Airview Boulevard, MN, USA) and A of the ankle. Methods: All patients that completed follow-up of at least 24 months after TJR and A of the ankle before November 5, 2017 were included in the study. The data was extracted from a prospectively acquired database starting November 1, 2011 including all operatively treated patient at the authors´ institution. Exclusion criteria were bilateral treatment (n=14), extensive additional procedures such as arthrodesis at other joints (n=54), A for revision of TJR (n=8), TJR exchange (n=10), and not completed minimum-24-month-follow-up (n=26). Preoperatively and at follow-up, radiographs and/or weight-bearing computed tomographies were obtained. Degenerative changes were classified in four degrees. Standard dynamic pedography was performed (percentage force at hindfoot and forefoot from force of entire foot). Visual-Analogue-Scale Foot and Ankle (VAS FA) and ankle range of motion for dorsi-/plantarflexion (ROM) were registered. All parameters were compared between TJR and A and between preoperatively and follow-up. Results: From October 11, 2011 until October 31, 2015, 36 TJR and 28 A were performed. Parameters (average values if not stated otherwise) for TJR/A were preoperatively age 61/52 years; 20(56%)/14(50%) male; height 171/175 cm; weight 83/87 kg; degree degenerative changes 3.5/3.6; ROM 5.6/0/22.8°//4.8/0/22.1°; percentage force hindfoot/forefoot 45.5/38.3//48.4/34.5; VAS FA 43.8/40.3. Follow-up time on average 35.8/33.1 and range 25.4-66.4/24.1-71.3 months. VAS FA at follow-up was 68.6/61.3; percentage force hindfoot/forefoot 64.3/22.3//53.5/28.5; ROM 15.4/0/33.6°//0/0/0. Parameters did not differ between TJR and A (each p>.05) except lower age for A, higher VAS FA, hindfoot force percentage and ROM for TJR at follow-up (each p<.05). VAS FA and pedography parameters improved for TJR and A between preoperatively and follow-up, ROM increased for TJR and decreased for A (each p<.05). Conclusion: TJR and A were performed in similar patient cohorts regarding demographic parameter (except lower age for A), degree of degenerative changes, ROM, pathological pedographic pattern, and validated clinical scores (VAS FA). Both improved pathological pedographic pattern and VAS FA at minimum follow-up of 24 months. TJR additionally improved ROM and showed better pedographic pattern (and not different than physiological pattern) and VAS FA than A. TJR resulted in better clinical outcome including ROM and pedographic pattern. Survival rate of TJR was 100% up to 5.5 years. In this study, TJR outperformed A for treatment of severe ankle osteoarthritis. |
| first_indexed | 2024-12-22T21:04:03Z |
| format | Article |
| id | doaj.art-6261b20f8bce424ca208c7d075c80e7c |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-12-22T21:04:03Z |
| publishDate | 2018-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-6261b20f8bce424ca208c7d075c80e7c2022-12-21T18:12:43ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142018-09-01310.1177/2473011418S00403Comparison Total Joint Replacement (STAR) with Arthrodesis of the AnkleMartinus Richter MD, PhDStefan Zech MDCategory: Ankle Arthritis Introduction/Purpose: Total joint replacement (TJR) and arthrodesis (A) are treatment options for severe osteoarthritis of the ankle. The aim of this study was to compare outcome (clinical and pedographic) of JTR (STAR, Stryker, Airview Boulevard, MN, USA) and A of the ankle. Methods: All patients that completed follow-up of at least 24 months after TJR and A of the ankle before November 5, 2017 were included in the study. The data was extracted from a prospectively acquired database starting November 1, 2011 including all operatively treated patient at the authors´ institution. Exclusion criteria were bilateral treatment (n=14), extensive additional procedures such as arthrodesis at other joints (n=54), A for revision of TJR (n=8), TJR exchange (n=10), and not completed minimum-24-month-follow-up (n=26). Preoperatively and at follow-up, radiographs and/or weight-bearing computed tomographies were obtained. Degenerative changes were classified in four degrees. Standard dynamic pedography was performed (percentage force at hindfoot and forefoot from force of entire foot). Visual-Analogue-Scale Foot and Ankle (VAS FA) and ankle range of motion for dorsi-/plantarflexion (ROM) were registered. All parameters were compared between TJR and A and between preoperatively and follow-up. Results: From October 11, 2011 until October 31, 2015, 36 TJR and 28 A were performed. Parameters (average values if not stated otherwise) for TJR/A were preoperatively age 61/52 years; 20(56%)/14(50%) male; height 171/175 cm; weight 83/87 kg; degree degenerative changes 3.5/3.6; ROM 5.6/0/22.8°//4.8/0/22.1°; percentage force hindfoot/forefoot 45.5/38.3//48.4/34.5; VAS FA 43.8/40.3. Follow-up time on average 35.8/33.1 and range 25.4-66.4/24.1-71.3 months. VAS FA at follow-up was 68.6/61.3; percentage force hindfoot/forefoot 64.3/22.3//53.5/28.5; ROM 15.4/0/33.6°//0/0/0. Parameters did not differ between TJR and A (each p>.05) except lower age for A, higher VAS FA, hindfoot force percentage and ROM for TJR at follow-up (each p<.05). VAS FA and pedography parameters improved for TJR and A between preoperatively and follow-up, ROM increased for TJR and decreased for A (each p<.05). Conclusion: TJR and A were performed in similar patient cohorts regarding demographic parameter (except lower age for A), degree of degenerative changes, ROM, pathological pedographic pattern, and validated clinical scores (VAS FA). Both improved pathological pedographic pattern and VAS FA at minimum follow-up of 24 months. TJR additionally improved ROM and showed better pedographic pattern (and not different than physiological pattern) and VAS FA than A. TJR resulted in better clinical outcome including ROM and pedographic pattern. Survival rate of TJR was 100% up to 5.5 years. In this study, TJR outperformed A for treatment of severe ankle osteoarthritis.https://doi.org/10.1177/2473011418S00403 |
| spellingShingle | Martinus Richter MD, PhD Stefan Zech MD Comparison Total Joint Replacement (STAR) with Arthrodesis of the Ankle Foot & Ankle Orthopaedics |
| title | Comparison Total Joint Replacement (STAR) with Arthrodesis of the Ankle |
| title_full | Comparison Total Joint Replacement (STAR) with Arthrodesis of the Ankle |
| title_fullStr | Comparison Total Joint Replacement (STAR) with Arthrodesis of the Ankle |
| title_full_unstemmed | Comparison Total Joint Replacement (STAR) with Arthrodesis of the Ankle |
| title_short | Comparison Total Joint Replacement (STAR) with Arthrodesis of the Ankle |
| title_sort | comparison total joint replacement star with arthrodesis of the ankle |
| url | https://doi.org/10.1177/2473011418S00403 |
| work_keys_str_mv | AT martinusrichtermdphd comparisontotaljointreplacementstarwitharthrodesisoftheankle AT stefanzechmd comparisontotaljointreplacementstarwitharthrodesisoftheankle |