Overnight Admission After Total Ankle Replacement: Is It Safe?

Jantzen, Christopher; Ebskov, Lars Bo; Andersen, Kim Hegnet; Benyahia, Mostafa; Rasmussen, Peter Bro; Johansen, Jens Kurt

doi:10.1053/j.jfas.2020.08.032

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…Day-case foot and ankle surgery is known to be safe for the patient with high satisfaction rates as well as being cost effective for the service[ 11 ]. There is recent evidence showing there were little to no differences in complication rates or readmissions following foot/ankle surgeries (total ankle replacements, ankle fractures, total ankle arthroplasty and hindfoot fusions) that were performed as day-case vs inpatient[ 12 - 17 ]. However there are no specific guidelines for foot and ankle day-case surgery.…”

Section: Introductionmentioning

confidence: 99%

Perceived barriers and facilitators of day-case surgery for major foot and ankle procedures? A cross-sectional survey of United Kingdom surgeons

Berry¹,

Houchen–Wolloff²,

Crane³

et al. 2023

World J Orthop

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BACKGROUND Advances in minimally invasive surgery and improved post-operative pain management make it possible to consider performing even major foot/ankle operations as day-case. This could have significant benefits for patients and the health service. However there are theoretical concerns about post-operative complications and patient satisfaction due to pain. AIM To scope the current practice of foot and ankle surgeons on day-case surgery for major foot and ankle procedures in the United Kingdom (UK). METHODS An online survey (19 questions) was sent to UK foot and ankle surgeons via the British Orthopaedic Foot & Ankle Society membership list in August 2021. Major foot and ankle procedures were defined as surgery that is usually performed as an inpatient in majority of centres and day-case as same day discharge, with day surgery as the intended treatment pathway. RESULTS 132 people responded to the survey invitation with 80% working in Acute NHS Trusts. Currently 45% of respondents perform less than 100 day-case surgeries per year for these procedures. 78% felt that there was scope to perform more procedures as day-case at their centre. Post-operative pain (34%) and patient satisfaction (10%) was not highly measured within their centres. Lack of adequate physiotherapy input pre/post-operatively (23%) and lack of out of hours support (21%) were the top perceived barriers to performing more major foot and ankle procedures as day-case. CONCLUSION There is consensus among UK surgeons to do more major foot/ankle procedures as day-case. Out of hours support and physiotherapy input pre/ post-op were perceived as the main barriers. Despite theoretical concerns about post-operative pain and satisfaction this was only measured by a third of those surveyed. There is a need for nationally agreed protocols to optimise the delivery of and measurement of outcomes in this type of surgery. At a local level, the provision of physiotherapy and out of hours support should be explored at sites where this is a perceived barrier.

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Section: Introductionmentioning

confidence: 99%

Perceived barriers and facilitators of day-case surgery for major foot and ankle procedures? A cross-sectional survey of United Kingdom surgeons

Berry¹,

Houchen–Wolloff²,

Crane³

et al. 2023

World J Orthop

View full text Add to dashboard Cite

show abstract

“…From the anatomic view, ankle site had approximately 1/2 to 3/5 the maximum cartilage thickness at weight-bearing areas as that of hip and knee (2.7mm vs 3-6mm) [2]. Thus, any abnormal alignment of the ankle would lead to local stress concentration and accelerate the degeneration of ankle cartilage and the formation of ankle arthritis [3]. It has been estimated that 20-40% of patients with acute ankle trauma like ankle sprain would develop chronic sprain, leading injury or even rupture of the lateral ligaments of the ankle, causing chronic lateral ankle instability and the secondary post-traumatic ankle arthritis [4].…”

Section: Introductionmentioning

confidence: 99%

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

Yang

Cui

Tao

et al. 2022

Preprint

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BackgroundPost-traumatic ankle arthritis is increasing, especially in young people and currently there is still lack of solid guidelines regarding its operative treatment. Ankle distraction arthroplasty and supramalleolar osteotomy are both options for such medical condition, but the studies comparing their clinical outcomes have been scarce. This study aimed to address this issue.MethodsThis was designed a retrospective study, enrolling 73 consecutive patients who underwent ankle distraction arthroplasty (n=32) or supramalleolar osteotomy (n=41) for post-traumatic ankle arthritis from January 2015 to December 2018. All patients had at least 24-month follow-ups. The outcome measures were the comparisons of the pre- and postoperative visual analog scale (VAS) for pain relief, the American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores, complications, patient-rated overall satisfaction and ankle function.ResultsAt an average of 32 months (range, 24 to 48 months) follow-up, both groups achieved significantly improved VAS and AOFAS scores compared to those at baseline (all p<0.05), but not significantly differed between groups (all p>0.05). The ankle distraction arthroplasty group had better postoperative ankle mobility than the supramalleolar osteotomy group, in terms of plantarflexion (37.8±4.2 vs 30.4±3.6, P=0.022), dorsiflexion (36.5±6.4 vs 28.3±5.5, P=0.011), varus (32.1±4.5 vs 27.1±3.1, P=0.029) and valgus (28.4±3.7 vs 25.2±2.8, P=0.047). Either, both groups did not differ in in the tibial anterior surface angle, talar tilt angle, tibial lateral surface angle, except for the correcting the load-bearing line of the ankle and hindfoot. The prevalence of postoperative complication was not significantly different between both groups (28.1% vs 17.1%, P=0.257). ConclusionsBoth ankle distraction arthroplasty and supramalleolar osteotomy are effective treatment options for Takakura-Tanaka stage 3 post-traumatic ankle arthritis, but with respective advantages and disadvantages. In practice, individualized treatment option tailored to the medical conditions and patients' specific need should be considered before a decision is made.

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Section: Introductionmentioning

confidence: 99%

Effect Analysis of Iliac Bone Autografting for Hepple V Osteochondral Lesions of The Talus

Wang

Zhang²,

Zhang

et al. 2021

Preprint

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BackgroundThis study aimed to analyze the efficacy of iliac bone autografting for Hepple V osteochondral lesions of the talus.MethodsThis retrospective study included 32 patients surgically treated for Hepple V osteochondral lesions of the talus from January 2015 to January 2020. All patients underwent open surgery. Ipsilateral iliac bone grafts were taken and filled with talar cartilage injury area. The improvement of postoperative ankle pain was evaluated by Visual Analogue Scale (VAS), and the improvement of ankle function was evaluated by the American Orthopaedic Foot & Ankle Society (AOFAS). During the postoperative follow-up, X-ray examination of the front and side of the ankle joint and CT of the ankle joint were performed to evaluate the bone cartilage healing in the graft area.ResultsThirty-two patients (32 ankles) (100%) returned for clinical and radiologic follow-up at an average of 28 (range, 24–36) months postoperatively. At 3 months postoperatively and at the last follow-up, the AOFAS scores were (80.4±3.6) and (89.2±6.4) respectively, which were significantly improved compared with the preoperative score (49.7 ± 8.1), and the difference was statistically significant (P<0.05). The VAS scores were (2.1±0.9) and (1.5±0.8) respectively, which were significantly better than the preoperative score (6.2±1.7), and the difference was statistically significant(P < 0.05). Re-examination of the front and side of the ankle joint x-rays and CT showed that the bone bone healing at the osteotomy of medial malleolus and osteochondral transplantation area. All patients had no pain at the donor site. No complications occurred in 32 patients at the last follow-up.ConclusionsWith iliac bone autografting for Hepple V osteochondral lesions of the talus can effectively relieve ankle joint pain and significantly improved ankle function. The clinical effect is remarkable.Level of evidence：Leve III, Retrospective series.

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Overnight Admission After Total Ankle Replacement: Is It Safe?

Cited by 4 publications

References 14 publications

Perceived barriers and facilitators of day-case surgery for major foot and ankle procedures? A cross-sectional survey of United Kingdom surgeons

Perceived barriers and facilitators of day-case surgery for major foot and ankle procedures? A cross-sectional survey of United Kingdom surgeons

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

Effect Analysis of Iliac Bone Autografting for Hepple V Osteochondral Lesions of The Talus

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