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Total ankle replacement in rheumatoid arthritis.
The Journal of Bone and Joint Surgery. American Volume
|March 1, 1984
Summary
Total ankle replacement surgery offers significant pain relief and good outcomes for select patients. Despite some limitations, this study shows promising results for total ankle arthroplasty in managing ankle arthritis.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Indications for total ankle-replacement arthroplasty remain debated.
- Previous studies on rheumatoid arthritis patients yielded disappointing results.
Purpose of the Study:
- To evaluate the outcomes of single-axis total ankle arthroplasty.
- To assess pain relief, range of motion, and implant survival.
Main Methods:
- Fifteen patients underwent single-axis total ankle arthroplasty (14 Mayo, 1 Buchholz).
- Average follow-up was 39 months.
- Radiographic assessment included evaluation of intertarsal joints.
Main Results:
- Excellent or good ratings were achieved in 14 out of 15 ankles.
- Gratifying pain relief was reported by all patients; only 4 had residual pain with activity.
- Average gain in range of motion was 9 degrees.
- No loosening requiring reoperation occurred, though radiolucent lines were observed in 11 ankles.
- 13 ankles showed moderate to severe arthritic changes in adjacent joints.
Conclusions:
- Single-axis total ankle arthroplasty can provide significant pain relief and functional improvement.
- Careful patient selection is crucial, considering pre-existing intertarsal joint arthritis.
- Long-term implant survival appears favorable, with no reoperations for loosening in this cohort.