Improved function seen after conversion of ankle arthrodesis to total ankle arthroplasty
Investigators of this study found conversion of ankle arthrodesis to total ankle arthroplasty improved function and offered pain relief to most patients at short-term follow-up.
“Patients who undergo this surgery frequently require concomitant procedures; we recommend prophylactic malleolar fixation when performing conversion total ankle arthroplasty,” the authors wrote. “The rate of complications, particularly talar component settling and migration, is cause for concern. We do not recommend the procedure for ankle arthrodeses that included distal fibulectomy.”
Researchers prospectively collected data for 23 ankles that were converted to total ankle arthroplasty after tibiotalar arthrodesis. Investigators used the SF-36, VAS and Short Musculoskeletal Function Assessment (SMFA) to assess patient-reported health and function. A goniometer was used to clinically evaluate ankle range of motion. Radiographs were evaluated twice by two foot and ankle surgeons during initial weight-bearing and at the last follow-up. The mean follow-up was 33.1 months.
Findings showed the mean preoperative VAS score improved about 47 points from preoperative evaluation to the most recent follow-up. Five patients were pain-free and eight patients had a VAS score of less than 10. SF-36 scores also improved from 37.7 to 56.4. The mean SMFA bother index score improved from 55 preoperatively to 30.6 postoperatively. The mean function index also improved from 46.7 to 25.4.
Investigators noted an implant survival rate of 87%. Radiographic evidence of stabilization following initial settling was seen in four patients with an unrevised tibial component and 14 patients with an unrevised talar component. Three ankle replacements were revised due to progressive talar subsidence. Overall, 43% of patients experienced minor complications that did not need surgery.‒ by Monica Jaramillo
Disclosures: Pellegrini reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.