Journal article
Deformity Correction in Ankle Osteoarthritis Using a Lateral Trans-Fibular Total Ankle Replacement: A Weight-Bearing CT Assessment
The Iowa orthopaedic journal, Vol.42(2), pp.36-46
2022
PMCID: PMC9769357
PMID: 36601228
Appears in Diamond Open Access
Abstract
Ankle osteoarthritis (AO) is often secondary to prior trauma and frequently presents with joint deformity. Total ankle replacement (TAR) has been shown as a viable surgical option to reduce pain, improve function, and preserve ankle joint range of motion. The standard TAR uses an anterior approach, but recently a lateral trans-fibular approach has been developed. Our aim was to determine if the lateral TAR was able to correct alignment and improve patient reported outcomes (PROs) in patients with end-stage AO.
This IRB-approved, retrospective comparative study included 14 consecutive patients that underwent lateral trans-fibular approach TAR for end-stage AO. All patients had received pre-and post-operative WBCT imaging on the affected foot and ankle. Using multiplanar reconstruction of WBCT images, measures of coronal and sagittal plane ankle alignment: Foot and Ankle Offset (FAO), Talar Tilt Angle (TTA), Hindfoot Moment Arm (HMA), and Lateral Talar Station (LTS) were performed. PROs were collected pre- and postoperatively at the latest clinical follow-up.
All patients demonstrated a significant deformity correction in all measurements performed: FAO (7.73%-3.63%, p=0.031), HMA (10.93mm - 5.10mm, p=0.037), TTA (7.9o-1.5o, p=0.003), and LTS (5.25mm-2.83mm, p=0.018). Four of the PROs measured exhibited significant improvement postoperatively, the Tampa Scale for Kinesiophobia (TSK) (42.7-34.5, p=0.012), PRO-MIS Global Physical Health (46.1-54.5, p=0.011), EFAS (5-10.3, p=0.004), and FAAM Daily Living (60.5-79.7, p=0.04). Multivariate analysis assessing the influence of deformity correction in the improvements of PROs found that PROMIS Global Physical Health was significantly associated with improvements in FAO and LTS, TSK associated with HMA, and FAAM Daily Living with FAO and TTA (p<0.05).
The results of this retrospective comparative cohort study suggest that the lateral trans-fibular TAR can correct different aspects of AO deformity. The method also impacted PROs, particularly TSK, PROMIS Global Physical Health, EFAS, and FAAM Daily Living. Direct correlation between some of the deformity correction measurements and the significantly improved PROs was found. The obtained data could help surgeons when making treatment decisions and be the base for comparative prospective studies.
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Details
- Title: Subtitle
- Deformity Correction in Ankle Osteoarthritis Using a Lateral Trans-Fibular Total Ankle Replacement: A Weight-Bearing CT Assessment
- Creators
- Christian VandeLune - University of IowaNacime Salomao Barbachan Mansur - University of IowaCaleb Iehl - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USATutku Tazegul - University of IowaSamuel J Ahrenholz - University of IowaKepler Alencar Mendes de Carvalho - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USACesar de Cesar Netto - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.42(2), pp.36-46
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 36601228
- PMCID
- PMC9769357
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Language
- English
- Date published
- 2022
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984355052802771
Metrics
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