Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis: A Prospective Randomized Controlled Trial

Charles L SALTZMAN; Stephen L HILLIS; Mary P STOLLEY; Donald D ANDERSON; Annunziato AMENDOLA

doi:10.2106/JBJS.K.00018

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Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis: A Prospective Randomized Controlled Trial

Journal article

Open access

Peer reviewed

Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis: A Prospective Randomized Controlled Trial

Charles L SALTZMAN, Stephen L HILLIS, Mary P STOLLEY, Donald D ANDERSON and Annunziato AMENDOLA

Journal of bone and joint surgery. American volume, Vol.94(11), pp.961-970

2012

DOI: 10.2106/JBJS.K.00018

PMCID: PMC3364029

PMID: 22637202

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Abstract

Background: Initial reports have shown the efficacy of fixed distraction for the treatment of ankle osteoarthritis. We hypothesized that allowing ankle motion during distraction would result in significant improvements in outcomes compared with distraction without ankle motion. Methods: We conducted a prospective randomized controlled trial comparing the outcomes for patients with advanced ankle osteoarthritis who were managed with anterior osteophyte removal and either (1) fixed ankle distraction or (2) ankle distraction permitting joint motion. Thirty-six patients were randomized to treatment with either fixed distraction or distraction with motion. The patients were followed for twenty-four months after frame removal. The Ankle Osteoarthritis Scale (AOS) was the main outcome variable. Results: Two years after frame removal, subjects in both groups showed significant improvement compared with the status before treatment (p < 0.02 for both groups). The motion-distraction group had significantly better AOS scores than the fixed-distraction group at twenty-six, fifty-two, and 104 weeks after frame removal (p < 0.01 at each time point). At 104 weeks, the motion-distraction group had an overall mean improvement of 56.6% in the AOS score, whereas the fixed-distraction group had a mean improvement of 22.9% (p < 0.01). Conclusion: Distraction improved the patient-reported outcomes of treatment of ankle osteoarthritis. Adding ankle motion to distraction showed an early and sustained beneficial effect on outcome.

Osteoarthritis

Miscellaneous. Osteoarticular involvement in other diseases

Orthopedic surgery

Diseases of the osteoarticular system

Biological and medical sciences

Medical sciences

Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases

Details

Title: Subtitle: Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis: A Prospective Randomized Controlled Trial
Creators: Charles L SALTZMAN - University of Iowa Hospital and Clinics, Iowa City, Iowa, United States
Stephen L HILLIS - University of Iowa Hospital and Clinics, Iowa City, Iowa, United States
Mary P STOLLEY - University of Iowa Hospital and Clinics, Iowa City, Iowa, United States
Donald D ANDERSON - University of Iowa Hospital and Clinics, Iowa City, Iowa, United States
Annunziato AMENDOLA - University of Iowa Hospital and Clinics, Iowa City, Iowa, United States
Resource Type: Journal article
Publication Details: Journal of bone and joint surgery. American volume, Vol.94(11), pp.961-970
DOI: 10.2106/JBJS.K.00018
PMID: 22637202
PMCID: PMC3364029
NLM abbreviation: J Bone Joint Surg Am
ISSN: 0021-9355
eISSN: 1535-1386
Publisher: Journal of Bone and Joint Surgery Incorporated; Boston, MA
Language: English
Date published: 2012
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Biostatistics; Orthopedics and Rehabilitation; Industrial and Systems Engineering
Record Identifier: 9984040392102771

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