Relationship Between Tibiotalar Joint Space and Ankle Function Following Ankle Surgery.

Area of Science:

• Orthopedic Surgery
• Radiology
• Biomechanical Engineering

Background:

• Joint-preserving ankle procedures aim to delay ankle arthrodesis (AA) or total ankle replacement (TAR).
• Accurate patient selection is crucial for successful joint-preserving ankle surgery.
• Preoperative ankle joint space width is a potential prognostic indicator.

Purpose of the Study:

• To investigate the relationship between preoperative ankle joint space width and outcomes following joint-preserving ankle surgery.
• To determine if a joint space of less than 2 mm predicts inferior results.

Main Methods:

• A prognostic comparative study included 251 adult patients with a minimum 2-year follow-up after joint-preserving ankle surgery.
• Preoperative weightbearing radiographs were used to measure ankle joint space.
• Standardized outcome questionnaires (FAAM, SF-12, Tegner) and patient satisfaction were assessed.

Main Results:

• Patients with a preoperative ankle joint space < 2 mm (n=43) reported significantly lower FAAM ADL, FAAM Sports, and SF-12 PCS scores compared to those with ≥ 2 mm (n=208).
• A positive correlation was observed between joint space width and FAAM ADL, FAAM Sports, and SF-12 PCS scores.
• Statistical significance was achieved for all comparisons (P < .001 to P = .006).

Conclusions:

• A preoperative ankle joint space < 2 mm is associated with significantly poorer outcomes after joint-preserving ankle surgery.
• These findings aid in patient selection for joint-preserving procedures.
• Clinicians can use joint space measurements to counsel patients on expected outcomes.