Intermediate-Term Follow-up After Ankle Distraction for Treatment of End-Stage Osteoarthritis

Nguyen, Mai P.; Pedersen, Douglas R.; Gao, Yubo; Saltzman, Charles L.; Amendola, Annunziato

doi:10.2106/jbjs.n.00901

Cited by 62 publications

(51 citation statements)

References 36 publications

(46 reference statements)

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“…Citations were stored in RefWorks (Proquest ® ) and screened for duplicates. Search strategies, results, and abstracts chosen for screening were managed using Microsoft ® Excel workbook designed for systematic reviews [14]. …”

Section: Methodsmentioning

confidence: 99%

Distraction arthroplasty compared to other cartilage preservation procedures in patients with post-traumatic arthritis: a systematic review

Rivera¹,

Beachler²

2018

Strategies in Trauma and Limb Reconstruction

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Post-traumatic arthritis (PTA) is characterized by the deterioration of articular cartilage temporally associated with an articular injury. With a paucity of literature comparing joint preservation techniques, we performed a systematic review of the literature intending to describe and summarize the results of ankle distraction arthroplasty as it compares with studies on tibio-talar microfracture, allograft, and autograft for ankle joint preservation in the post-traumatic population under 50 years of age. Research databases were searched and abstracts screened for relevance on our topic of interest. Abstracts meeting screening criteria with high interobserver reliability underwent full-manuscript review and coding for pertinent citation, study level, treatment, and outcome variables. Outcome variables for patient-reported pain scales, validated outcome measurement tools, radiographic progression, reoperation/re-treatment rates, and complication rates were recorded. Out of 105 unique citations, 10 publications were included. The distraction arthroplasty studies had 36 out of 181 patients requiring reoperation for complications (19.9%), while other joint-preserving procedures studies had 40 out of 177 patients requiring reoperations for complications (22.6%). Clinical outcome scores at mean follow-up time ranging from 2 to 10 years between studies were similar. Reported results for a variety of cartilage preservation procedures, including distraction arthroplasty, are satisfactory and reoperation rates for complication are similar. Limitations in available data and underlying study quality affect synthesis of the results therein. While distraction arthroplasty is an option for cartilage preservation in patients with PTA of the ankle, the technique is highly specialized which may affect the external validity.Level of evidence: III.

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Section: Methodsmentioning

confidence: 99%

Distraction arthroplasty compared to other cartilage preservation procedures in patients with post-traumatic arthritis: a systematic review

Rivera¹,

Beachler²

2018

Strategies in Trauma and Limb Reconstruction

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“…Although this tissue is likely not true articular cartilage, its presence has been shown to significantly decrease pain in the majority of cases and to be a long lasting remedy for a condition that would otherwise commonly be treated with arthrodesis. [2]…”

Section: Introductionmentioning

confidence: 99%

Development of a Simplified Ankle Distractor

Baer

Frisbie

Willey

et al. 2017

2017 Design of Medical Devices Conference

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The physical impairment caused by OA of a single lower extremity joint is comparable to that reported for major life-altering disorders such as end-stage kidney disease and heart failure. (Buckwalter, et al) [1] Ankle distraction arthroplasty has been shown to greatly decrease pain due to end-stage ankle arthritis. Unlike arthrodesis (fusion of the joint), distraction arthroplasty maintains the joint’s natural movement, and it is far less complicated than total joint replacement surgery. There is a considerable body of research supporting the idea that distraction of an end-stage arthritic joint (most of the work thus far has been done on ankles, although there has also been some investigation of the efficacy of the treatment for knee arthritis) for a period of weeks allows the growth of new tissue in the joint. Although this tissue is not true articular cartilage, distraction arthroplasty has been shown to significantly decrease pain and, in the majority of cases, to be a long lasting remedy for a condition that would otherwise commonly be treated with arthrodesis. [2] Devices currently available for this procedure are generally quite complicated because they are designed for a wide range of functions related to bone fixation. This versatility also tends to make those systems larger and more expensive, and their aggressively mechanical appearance makes potential joint distraction patients hesitant to select the procedure. While fracture patients may not have a choice about being treated with such devices, elective patients are instinctively resistant to their use, even when assured that the end result will most likely significantly improve in the quality of their lives.

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“…While numerous studies addressed clinical outcomes following distraction arthroplasty in patients with primary or posttraumatic ankle osteoarthritis [40,43,44], there are only two studies highlighting this treatment option in patients with haemophilic ankle arthropathy [45,46]. Van Meegeren et al [45] treated three patients with haemophilic ankle arthropathy using joint distraction with an Ilizarov external fixator.…”

Section: Distraction Arthroplastymentioning

confidence: 99%

Surgical procedures in patients with haemophilic arthropathy of the ankle

et al. 2016

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Intermediate-Term Follow-up After Ankle Distraction for Treatment of End-Stage Osteoarthritis

Abstract: Ankle function following joint distraction declines over time. Patients should be well informed of the commitment that they must make during the treatment period as well as the long-term results after surgery.

Cited by 62 publications

References 36 publications

Distraction arthroplasty compared to other cartilage preservation procedures in patients with post-traumatic arthritis: a systematic review

Distraction arthroplasty compared to other cartilage preservation procedures in patients with post-traumatic arthritis: a systematic review

Development of a Simplified Ankle Distractor

Surgical procedures in patients with haemophilic arthropathy of the ankle

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