Long-Term Results Following Ankle Arthrodesis for Post-Traumatic Arthritis

Coester, Lisa M.; Saltzman, Charles L.; Leupold, John A.; Pontarelli, William

doi:10.2106/00004623-200102000-00009

Cited by 724 publications

(458 citation statements)

References 18 publications

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“…Furthermore, the rehabilitation potential or neuromuscular protective mechanisms in OA are known to be reduced in elderly patients owing to such factors as sarcopenia, reduced proprioception, and increased physical disability [19,24]. Based on these aging aspects of tissues and the known relatively large latency time for development of ankle OA [3,27,43], the mean age and age distribution of our cohort (Fig. 1) might be explainable.…”

Section: Discussionmentioning

confidence: 85%

Etiology of Ankle Osteoarthritis

Valderrábano

Horisberger

Russell³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

677

415

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The purpose of this study was to evaluate the distribution rate of etiologies leading to ankle arthritis and to quantify and compare the important clinical and radiologic variables among these etiologic groups. We evaluated data from 390 patients (406 ankles) who consulted our center because of painful end-stage ankle osteoarthritis (OA) by using medical history, physical examination, and radiography. Posttraumatic ankle OA was seen in 78% of the cases (n = 318), secondary arthritis in 13% (n = 52), and primary OA in 9% (n = 36). The average American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score was 38 points (range, 0-74 points), range of motion was 22°(range, 0°-65°), and visual analog scale for pain was 6.8 (range, 2-10). Patients with posttraumatic endstage ankle OA were younger than patients with primary OA. The average tibiotalar alignment was 88°(range, 51°-116°) and did not differ between the etiologic groups. Our study showed trauma is the main cause of ankle OA and primary OA is rare. In the majority of patients with ankle OA the average tibiotalar alignment is varus regardless of the underlying etiology.

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Section: Discussionmentioning

confidence: 85%

Etiology of Ankle Osteoarthritis

Valderrábano

Horisberger

Russell³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

677

415

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“…Patients for whom nonoperative management fails may be offered surgery. Ankle fusion reduces pain at the cost of loss of ankle motion, altered gait kinematics [19,27], and accelerated arthritis in surrounding joints [5]. Patients also have a 3% to 10% risk of nonunion [13,20].…”

Section: Introductionmentioning

confidence: 99%

Is Total Ankle Arthroplasty A Cost-effective Alternative to Ankle Fusion?

Courville

Hecht

Tosteson

2011

Clinical Orthopaedics &Amp; Related Research

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Background Total ankle arthroplasty (TAA) implantation is increasing, as the potential for pain relief and restoration of function and risks are compared with those for ankle fusion. A previous analysis with a simple decision tree suggested TAA was cost-effective compared with ankle fusion. However, reevaluation is warranted with the availability of newer, more costly implants and longer-term patient followup data. Questions/purposes Considering all direct medical costs regardless of the payer, we determined if TAA remains a cost-effective alternative to ankle fusion when updated evidence is considered. Patients and Methods Using a Markov model, we evaluated expected costs and quality-adjusted life years (QALY) for a 60-year-old hypothetical cohort with endstage ankle arthritis treated with either TAA or ankle fusion. Costs were estimated from 2007 diagnosis-related group (DRG) and current procedural terminology (CPT) codes for each procedure. Rates were extracted from the literature. The incremental cost-effectiveness ratio (ICER), a measure of added cost divided by QALY gained for TAA relative to ankle fusion, was estimated. To identify factors affecting the value of TAA, sensitivity analyses were performed on all variables.

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“…Subtalar degenerative changes are commonly seen in patients following ankle fusion, less common talonavicular, and rarely calcaneocuboid degenerative changes are seen. [18][19][20] We have compared some parameters of our study with another similar study from the literature. Winson (Table 4).…”

Section: Discussionmentioning

confidence: 99%