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Total Ankle Replacement for Osteoarthritis Following Pilon Fracture of the Tibia

Lookup NU author(s): Adam Bennett, Jayasree Ramaskandhan, Malik Siddique


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© The Author(s) 2018. Background: Outcomes for total ankle replacement (TAR) performed for osteoarthritis following pilon fracture are underreported. We compared the outcomes between different indications for TAR. Methods: Patient-reported outcome measures (PROMs) for TAR performed from 2006 to 2014 by a single surgeon were reviewed. Foot and Ankle Outcome Score (FAOS), SF-36, comorbidities, self-reported body mass index (BMI), and patient satisfaction scores were reviewed. Data were collected preoperatively and at 1 and 2 years postoperatively. Clinical notes and radiographs highlighted the indication for TAR. The following subgroups were created: osteoarthritis (OA), rheumatoid arthritis (RA), pilon fracture (PF), ankle fracture (AF), and posttraumatic arthritis without previous fracture (PTOA). PROMs were available for 173 TARs: 89 (51.4%) for OA, 36 (20.8%) for AF, 21 (12.1%) for RA, 15 (8.7%) for PF, and 12 (6.9%) for PTOA. The pilon fracture group were the youngest and had the highest BMI (mean, 56.5 years; mean BMI, 31.6 kg/m2). No difference was found in number of reported comorbidities (P >.05). Results: Significant improvement in FAOS scores was seen in all subgroups from preoperatively to 1 year (P =.01,.05, and.03). SF-36 had similar results for all subgroups with improvement in all parameters by 2 years. Significant improvement in role physical and role emotional domains was seen by 1 year following TAR (P =.018 and P =.042). Patient satisfaction scores were similar in each group. There was no major difference in any of the reported outcomes between subgroups by 2 years postoperatively. Conclusion: We found similar outcomes for patients who underwent TAR after pilon fracture compared to other indications. Level of Evidence: Level III, comparative study.

Publication metadata

Author(s): Bennett A, Ramaskandhan J, Siddique M

Publication type: Article

Publication status: Published

Journal: Foot and Ankle International

Year: 2018

Volume: 39

Issue: 9

Pages: 1008-1018

Print publication date: 01/09/2018

Online publication date: 15/08/2018

Acceptance date: 02/04/2018

ISSN (print): 1071-1007

ISSN (electronic): 1944-7876

Publisher: SAGE Publications Inc.


DOI: 10.1177/1071100718793091


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