Similar improvements in patient outcome measures found with ankle arthrodesis, replacement
Despite similar improvements in comfort and function after ankle arthrodesis or total ankle replacement, results published in The Journal of Bone and Joint Surgery showed total ankle replacement performed with newer generation implants had better patient-reported outcomes.
“This prospective, multicenter cohort trial comparing patient-reported outcomes from ankle replacement and ankle arthrodesis showed clinically significant improvement with both treatments, with better patient-reported outcomes and pain scores in the group treated with ankle replacement at 3-years postop,” Bruce J. Sangeorzan, MD, told Healio.com/Orthopedics.
Sangeorzan and colleagues collected pain scores, musculoskeletal function assessment and SF-36 surveys at baseline and at 6 months, 12 months, 24 months and 36 months from 273 patients with ankle arthritis treated with either ankle arthrodesis or total ankle replacement (TAR).
Regardless of procedure, results showed a significant mean improvement in most outcomes after surgery, with the greatest improvement occurring during the first 6 months of follow-up. At 6 months, scores improved by a mean of approximately 12.6 on the musculoskeletal function assessment, 22 on the SF-36 physical function scale, 32.4 on the SF-36 bodily pain scale and 4 on the pain rating scale, according to results from the linear mixed-effects regression analysis that was adjusted for differences at baseline in age, BMI and surgery type.
Researchers found significantly better mean improvements in the musculoskeletal function assessment and SF-36 physical function scale after TAR vs. arthrodesis. However, researchers noted these differences were only slightly greater when surgeons used the newer TAR devices. – by Casey Tingle
Disclosures: Sangeorzan reports he received grants from the U.S. Department of Veterans Affairs. Please see the full study for a list of all other authors’ relevant financial disclosures.