Functional and Clinical Assessment of Two Ankle Arthrodesis Techniques

Malerba, Francesco; Benedetti, Maria Grazia; Usuelli, Federico Giuseppe; Milani, Rossano; Berti, Lisa; Champlon, Christine; Leardini, Alberto

doi:10.1053/j.jfas.2014.09.007

Cited by 14 publications

(12 citation statements)

References 28 publications

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“…physical examination, Mazur score, 15 stereophotograpmmetric system. 22 One study showed abnormalities found using gait analysis and demonstrated reduced ROM at the subtalar joint in both groups, consistent with the K-M scores. 22 A positive correlation between the SF-36 score and ROM was shown in another paper, 23 but no significant difference between the two lower limbs throughout the gait cycle with these measures.…”

Section: Clinical Outcomessupporting

confidence: 61%

“…Technically, the AOFAS ankle-hindfoot score and Mazur scores are clinician reported measures but are widely used as PROMs comprising of pain, function, alignment (AOFAS) or ROM (Mazur). Other PROMs included were the Kellgren and Moore (K-M) system for OA, 22 the OA Dijk score, 21 MT and ST (Metatarsal and Subtalar) score, 22 FAAM (foot and ankle ability measure) 21 and SF-36 (36-item short form survey). 20 Interestingly the ManchestereOxford foot questionnaire (MOXFQ) was not mentioned in the articles screened, despite its popularity in UK clinical practice.…”

Section: Patient Reported Outcome Measures (Proms)mentioning

confidence: 99%

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The need for a paradigm shift in the rehabilitation of elective foot and ankle reconstructive surgery patients? An annotation

Essop-Adam

Houchen-Wolloff

Vaishya

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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Current surgeon established protocols encourage late weight bearing and prolonged immobilisation after ankle, hind-and mid-foot fusion surgery. There is no universal guidance regarding early mobilisation and rehabilitation after this type of surgery. There is a paucity of research in this area but early mobilisation may be beneficial in terms of improved clinical and patient reported outcome measures, whilst still offering good union and very few complications.Feasibility work prior to a full-scale trial is now needed to explore the efficacy of early functional mobilisation, prior to any adoption within clinical practice. A paradigm shift in the early post-operative management of this patient group has the potential to improve outcomes for patients and decrease the socioeconomic burden on the health service.

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Section: Clinical Outcomessupporting

confidence: 61%

Section: Patient Reported Outcome Measures (Proms)mentioning

confidence: 99%

The need for a paradigm shift in the rehabilitation of elective foot and ankle reconstructive surgery patients? An annotation

Essop-Adam

Houchen-Wolloff

Vaishya

et al. 2020

Journal of Clinical Orthopaedics and Trauma

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“…The type of deformity dictates the correction required as well as site of correction. Malerba et al (2015) report of no significant difference in both isolated tibiotalar and combined tibiotalar subtalar fusion. While isolated tibiotalar fusion does allow for some motion at the subtalar joint, there is associated morbidity of degenerative changes in this area (Malerba et al 2015).…”

Section: Discussionmentioning

confidence: 86%

“…Malerba et al (2015) report of no significant difference in both isolated tibiotalar and combined tibiotalar subtalar fusion. While isolated tibiotalar fusion does allow for some motion at the subtalar joint, there is associated morbidity of degenerative changes in this area (Malerba et al 2015). Severe ankle and hindfoot conditions that cannot be adequately managed by other measures, can be treated using hindfoot fusion which act as a salvage option that offers a safe and reliable treatment (Rammelt et al 2013).…”

Section: Discussionmentioning

confidence: 86%

Functional Outcome of Hindfoot Arthrodesis in Charcot Arthropathy

Bajuri¹

2019

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Charcot arthropathy is a devastating degenerative condition which affects one or more joints that is marked by joint instability, hypermobility resulted from peripheral nerve damage. This was a retrospective study performed on patients who were diagnosed with Charcot arthropathy and those underwent surgery for hindfoot arthrodesis at Universiti Kebangsaan Malaysia Medical Centre from January 2011 until June 2016. The objective of the study was to review the feasibility of an algorithm in managing Charcot arthropathy and to assess functional, clinical and radiographic outcomes of Charcot arthropathy joints treated with hindfoot arthrodesis, at least 6 months follow-up using standardized and internationally accepted scoring systems, which were the American Orthopaedic Foot and Ankle Surgery (AOFAS) score and SF36. A total of 16 patients were included in this study of which 4 (25%) were males and 12 (75%) were females. The mean age was 58.1 (20-71) years. There was equal distribution for side of fusion. We achieved union in 13 out of our 16 (81%) cases followed up. Out of the 3 patients with non-union, 2 were attributed to deep infections. The AOFAS scores for hindfoot and midfoot showed significant improvement post operatively with p-value <0.05 as well as the SF36 mental scores with p-value <0.05. The Physical Component of SF36 showed no improvement. The treatment algorithm currently used in our centre is acceptable and shows good outcomes. While the outcomes are of acceptable rates, efforts should now focus on reducing the complications as the burden of infection and non-union remains a known complication for most bone-related surgeries.

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“…Impairments following tibiotalar arthrodesis are often attributed to post‐operative changes in ankle motion. Specifically, in vivo biomechanical studies demonstrate that tibiotalar arthrodesis decreases ankle range of motion, thereby leading to abnormal, inefficient gait . In patients with unilateral tibiotalar arthrodesis, asymmetric gait is also a well‐recognized clinical problem .…”

mentioning

confidence: 99%

Ankle strength, muscle size, and adipose content following unilateral tibiotalar arthrodesis

Nichols

Foreman

Barg

et al. 2019

Journal Orthopaedic Research

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Tibiotalar arthrodesis is commonly used to treat end-stage ankle osteoarthritis. Post-operative impairments are often attributed to limited ankle motion. However, whether muscular deficits also exist, thereby potentially contributing to impairments, is unknown. This study aimed to identify post-operative deficits in ankle musculature by examining range of motion, strength (maximum isometric ankle joint torque), and leg composition (cross-sectional area of individual tissue types: bone, subcutaneous adipose, intramuscular adipose, muscle). Ten individuals with unilateral tibiotalar arthrodesis participated. Paired t-tests (p < 0.05) identified differences between the fused and contralateral, control limb. The results indicate that individuals with tibiotalar arthrodesis have profound losses of range of motion and strength. Across participants, range of motion in the fused limb was 53.5 AE 11.7%, 66.8 AE 6.3%, 38.2 AE 18.7%, 37.8 AE 13.6% less than the control for dorsiflexion, plantarflexion, inversion, and eversion, respectively. The largest strength deficit was in dorsiflexion, with the fused limb producing 47.2 AE 9.4% less torque than the control. The quantity and quality of muscle tissue was also negatively affected in individuals following tibiotalar arthrodesis. The total cross-sectional area of the fused limb was 11.4 AE 5.4% smaller than the control limb. This change was primarily due to the 16.1 AE 6.7% decrease in muscle cross-sectional area. However, intramuscular adipose was significantly increased. Although the posterior compartment demonstrated a significant decrease in cross-sectional area, when accounting for differences in total cross-sectional area, the relative sizes of the four muscle compartments were consistent between limbs. This cross-sectional study motivates longitudinal research examining muscular deficits and whether these deficits are reversible with exercise and rehabilitation. ß

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Functional and Clinical Assessment of Two Ankle Arthrodesis Techniques

Cited by 14 publications

References 28 publications

The need for a paradigm shift in the rehabilitation of elective foot and ankle reconstructive surgery patients? An annotation

The need for a paradigm shift in the rehabilitation of elective foot and ankle reconstructive surgery patients? An annotation

Functional Outcome of Hindfoot Arthrodesis in Charcot Arthropathy

Ankle strength, muscle size, and adipose content following unilateral tibiotalar arthrodesis

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