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Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis.

Publication ,  Journal Article
Lewis, JS; Adams, SB; Queen, RM; DeOrio, JK; Nunley, JA; Easley, ME
Published in: Foot Ankle Int
June 2014

BACKGROUND: Ipsilateral hindfoot arthrodesis in combination with total ankle replacement (TAR) may diminish functional outcome and prosthesis survivorship compared to isolated TAR. We compared the outcome of isolated TAR to outcomes of TAR with ipsilateral hindfoot arthrodesis. METHODS: In a consecutive series of 404 primary TARs in 396 patients, 70 patients (17.3%) had a hindfoot fusion before, after, or at the time of TAR; the majority had either an isolated subtalar arthrodesis (n = 43, 62%) or triple arthrodesis (n = 15, 21%). The remaining 334 isolated TARs served as the control group. Mean patient follow-up was 3.2 years (range, 24-72 months). RESULTS: The SF-36 total, AOFAS Hindfoot-Ankle pain subscale, Foot and Ankle Disability Index, and Short Musculoskeletal Function Assessment scores were significantly improved from preoperative measures, with no significant differences between the hindfoot arthrodesis and control groups. The AOFAS Hindfoot-Ankle total, function, and alignment scores were significantly improved for both groups, albeit the control group demonstrated significantly higher scores in all 3 scales. Furthermore, the control group demonstrated a significantly greater improvement in VAS pain score compared to the hindfoot arthrodesis group. Walking speed, sit-to-stand time, and 4-square step test time were significantly improved for both groups at each postoperative time point; however, the hindfoot arthrodesis group completed these tests significantly slower than the control group. There was no significant difference in terms of talar component subsidence between the fusion (2.6 mm) and control groups (2.0 mm). The failure rate in the hindfoot fusion group (10.0%) was significantly higher than that in the control group (2.4%; p < 0.05). CONCLUSION: To our knowledge, this study represents the first series evaluating the clinical outcome of TARs performed with and without hindfoot fusion using implants available in the United States. At follow-up of 3.2 years, TAR performed with ipsilateral hindfoot arthrodesis resulted in significant improvements in pain and functional outcome; in contrast to prior studies, however, overall outcome was inferior to that of isolated TAR. LEVEL OF EVIDENCE: Level II, prospective comparative series.

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Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

June 2014

Volume

35

Issue

6

Start / End Page

535 / 542

Location

United States

Related Subject Headings

  • Orthopedics
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
  • 1103 Clinical Sciences
 

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Lewis, J. S., Adams, S. B., Queen, R. M., DeOrio, J. K., Nunley, J. A., & Easley, M. E. (2014). Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis. Foot Ankle Int, 35(6), 535–542. https://doi.org/10.1177/1071100714528495
Lewis, John S., Samuel B. Adams, Robin M. Queen, James K. DeOrio, James A. Nunley, and Mark E. Easley. “Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis.Foot Ankle Int 35, no. 6 (June 2014): 535–42. https://doi.org/10.1177/1071100714528495.
Lewis JS, Adams SB, Queen RM, DeOrio JK, Nunley JA, Easley ME. Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis. Foot Ankle Int. 2014 Jun;35(6):535–42.
Lewis, John S., et al. “Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis.Foot Ankle Int, vol. 35, no. 6, June 2014, pp. 535–42. Pubmed, doi:10.1177/1071100714528495.
Lewis JS, Adams SB, Queen RM, DeOrio JK, Nunley JA, Easley ME. Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis. Foot Ankle Int. 2014 Jun;35(6):535–542.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

June 2014

Volume

35

Issue

6

Start / End Page

535 / 542

Location

United States

Related Subject Headings

  • Orthopedics
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
  • 1103 Clinical Sciences