Clinical outcome results of total ankle replacement and ankle arthrodesis: a pilot randomised controlled trial. Issue 3 (April 2021)

• Record Type: Journal Article
• Authors: Glazebrook, Mark; Burgesson, Bernard N.; Younger, Alastair S.; Daniels, Timothy R.
• Is Part Of: Foot and ankle surgery. Volume 27:Issue 3(2021)
• Page Start: 326
• Page End: 331
• Publication Date: 2021-04
• Subjects: End stage ankle osteoarthritis -- Ankle arthroplasty -- Ankle arthrodesis -- Ankle replacement -- Ankle fusion -- Ankle osteoarthritis; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2020.10.005
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: End-stage ankle arthritis (ESAA) is most commonly caused by trauma. Ankle Arthrodesis (AA) has been the gold standard treatment modality for ESAA. Total Ankle Arthroplasty (TAA) has emerged as potentially non-inferior option for ESAA. There are retrospective and prospective studies that support the equivalence of TAA and AA in treating ESAA, however, there remains the need for higher level evidence in form of randomised controlled trials. TAA and AA confer similar clinical outcomes results when used in treating ESAA. Abstract: Background: Ankle arthrodesis (AA) and replacement (TAA) are widely accepted options in managing end-stage ankle arthritis (ESAA). We hypothesize that clinical outcomes would be similar for both interventions. Methods: We conducted a multicenter randomized controlled trial that collected data on patient demographics, complication rates, Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) scores. We evaluated pre and postoperative scores within and between cohorts. Results: The thirty-nine ankles enrolled had a mean follow-up of 5.1 ± 2.8 years. Total AOS scores improved significantly in both groups; 59.4 ± 15.9 to 38 ± 20 ( p-value = 0.002 ) for TAA and 64.6 ± 19.7 to 31.8 ± 16.5 ( p-value < 0.001 ) for AA at last follow-up. Complication rate was higher in the AA cohort with four major complications (20%). Conclusion: We observed a statistically significant benefit with TAA and AA. As a pilot trial, this study is meant to inform on design and feasibility of future RCTs. Level of evidence: II