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Early results of a novel technique: Hindfoot fusion in talus osteonecrosis prior to ankle arthroplasty: A case series

Lookup NU author(s): Jayasree Ramaskandhan, Karthikeyan Muthumayandi, Malik Siddique


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© 2015 Elsevier Ltd. Background: The purpose of this study was to evaluate the clinical outcome of a two staged approach of subtalar arthrodesis followed by TAR for patients with ankle arthritis and AVN talus. Methods: Out of total 210 TARs performed at our institute; 7 patients underwent a two staged procedure between 2006 and 2010. All patients had over 3 years of follow up (except one). The clinical results were assessed using AOFAS, WOMAC, SF-36 and patient satisfaction scores. Results: The mean follow up was 3 years. There was significant improvement in AOFAS and WOMAC (pain and stiffness) from pre-op to 3 years post-op (P< 0.05). SF 36 scores improved from pre-op to 3 years post-op for 6/8 domains. 5 patients were satisfied at 3 years for overall surgical outcomes, 4 were satisfied with pain relief. Radiological signs of talar subsidence were noted in 2 patients at year 1. This did not progress at 3 years and did not deteriorate clinical outcome. Conclusion: We recommend our two staged approach to deal with this difficult clinical problem. We believe this approach is safe for TAR surgery where talar vascularity and bone quality is questionable leading to reduced talar subsidence, ischaemic pain and improvement in longevity of TAR. Level of evidence: Evidence IV (Retrospective case series).

Publication metadata

Author(s): Devalia KL, Ramaskandhan J, Muthumayandi K, Siddique M

Publication type: Article

Publication status: Published

Journal: The Foot

Year: 2015

Volume: 25

Issue: 4

Pages: 200-205

Print publication date: 01/12/2015

Online publication date: 26/07/2015

Acceptance date: 06/07/2015

ISSN (print): 0958-2592

ISSN (electronic): 1532-2963

Publisher: Churchill Livingstone


DOI: 10.1016/j.foot.2015.07.001

PubMed id: 26363580


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