Ankle distraction arthroplasty for the treatment of severe ankle arthritis

Abstract

Rationale: Widely applied in the treatment of severe ankle arthritis (AA), ankle distraction arthroplasty (ADA) can avoid not only the ankle range of motion loss but also ankle fusion. However, the clinical outcomes of ADA for severe AA are poorly understood. This study aims to present our clinical outcomes of severe AA treated by ADA. Patient concerns: A 53-year-old man suffered right ankle sprain 10 years ago, endured right ankle pain and limited movement for 6 years. Diagnosis: The patient was diagnosed as severe AA. Interventions: He received ankle distraction arthroplasty. No adjuvant procedures were performed. The visual analog scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, the short-form (SF)-36 physical component summary (PCS) score and ankle activity score (AAS) were recorded to access the clinical outcomes pre- and postoperatively. Moreover, ankle joint space distance was evaluated on weight-bearing radiographs. Outcomes: The patient derived effective pain relief and restored a satisfactory range of movement. There was a 13-month follow-up period after frame removal. The AOFAS score improved from 56 preoperatively to 71 postoperatively. The VAS score decreased from 6 prior to surgery to 1 after surgery. The SF-36 PCS was 47.2 and 71.8 pre- and postoperative, respectively. The AAS scores were improved from 3.4 preoperatively to 7.3 postoperatively. Lessons: ADA is reliable to achieve pain relief, functional recovery, and serve AA resolution. Besides, it is an alternative to ankle arthrodesis or total ankle arthroplasty in selected patients with severe AA.

Clinical Outcomes of Ankle Distraction Arthroplasty Versus Supramalleolar Osteotomy for Treatment of Post-Traumatic Ankle Arthritis

“…Various surgical treatment regimens have been used in clinical practice [8, [10][11][12][13][14], but the optimal option remains unclari ed. The present study retrospectively analyzed 73 patients with Takakura-Tanaka stage 3 post-traumatic ankle arthritis treated with either ankle distraction arthroplasty or supramalleolar osteotomy.…”

Clinical Outcomes of Ankle Distraction Arthroplasty Versus Supramalleolar Osteotomy

“…The treatment methods for post-traumatic ankle arthritis include conservative treatment [4], arthroscopic surgery [14], osteotomy around the ankle [21], ankle distraction arthroplasty [22], ankle arthrodesis [14][23], total ankle arthroplasty [24], and combined internal and external xation surgery [12]. However, the optimal treatment remains unclari ed.…”

“…The basic principle is to reduce the abnormal mechanical stress of the ankle through physical means, promote the intermittent ow of synovial uid in the joint, and reduce the ankle joint. The loaded articular cartilage has a certain self-healing ability that enables this method to treat ankle arthritis [22][26] [27]. Ankle distraction arthroplasty is mainly suitable for ankles with good alignment and peripheral pain, but requires ankle joint movement; this method can also be used as a pre-treatment before ankle fusion or replacement surgery in young patients with an ankle range of motion of greater than 20°.…”