Tibiotalar Arthrodesis with the Tibial Compression Nail

Mückley, Thomas; Hofmann, Gunther O.; Bühren, V.

doi:10.1007/s00068-007-1151-y

Cited by 13 publications

(15 citation statements)

References 11 publications

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“…A total of five studies met the inclusion criteria for pooled data analysis of outcomes after ankle arthrodesis (Table 2) [8–12]. All studies were retrospective in nature.…”

Section: Resultsmentioning

confidence: 99%

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Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade

et al. 2017

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BackgroundThe surgical treatment of end-stage tibiotalar arthritis continues to be a controversial topic. Advances in surgical technique and implant design have lead to improved outcomes after both ankle arthrodesis (AA) and total ankle arthroplasty (TAA), yet a clear consensus regarding the most ideal form of treatment is lacking. In this study, the outcomes and complications following AA and TAA are compared in order to improve our understanding and decision-making for care and treatment of symptomatic tibiotalar arthritis.MethodsStudies reporting on outcomes and complications following TAA or AA were obtained for review from the PubMed database between January 2006 and July 2016. Results from studies reporting on a minimum of 200 total ankle arthroplasties or a minimum of 80 ankle arthrodesis procedures were reviewed and pooled for analysis. All studies directly comparing outcomes and complications between TAA and AA were also included for review. Only studies including modern third-generation TAA implants approved for use in the USA (HINTEGRA, STAR, Salto, INBONE) were included.ResultsA total of six studies reporting on outcomes following TAA and five reporting on outcomes following AA met inclusion criteria and were included for pooled data analysis. The adjusted overall complication rate was higher for AA (26.9%) compared to TAA (19.7%), with similar findings in the non-revision reoperation rate (12.9% for AA compared to 9.5% for TAA). The adjusted revision reoperation rate for TAA (7.9%) was higher than AA (5.4%). Analysis of results from ten studies directly comparing TAA to AA suggests a more symmetric gait and less impairment on uneven surfaces after TAA.ConclusionsPooled data analysis demonstrated a higher overall complication rate after AA, but a higher reoperation rate for revision after TAA. Based on the existing literature, the decision to proceed with TAA or AA for end-stage ankle arthritis should be made on an individual patient basis.

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“…A total of five studies met the inclusion criteria for pooled data analysis of outcomes after ankle arthrodesis (Table 2) [8–12]. All studies were retrospective in nature.…”

Section: Resultsmentioning

confidence: 99%

“…Still, despite successful arthrodesis, loss of normal ankle motion has been shown to negatively affect functional status at long-term follow-up [7]. Greater attention to soft tissue management and newer fixation options has resulted in fewer complications, higher fusion rates, and more predictable pain relief [8–12]. …”

Section: Introductionmentioning

confidence: 99%

Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade

et al. 2017

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“…24 In their series of anterior open arthrodeses, Gordon et al 10 and Zwipp et al 40 reported rates of 2.4% and 5.3%, respectively. In Mückley et al’s 31 retrospective study on 137 arthrodeses performed using a lateral approach with a tibial compression nail, 10% of patients experienced a superficial or deep infection. Chalayon et al 2 further reported a 14.4% wound complication rate in 215 uncomplicated primary open ankle arthrodeses.…”

Section: Discussionmentioning

confidence: 99%

Ankle Arthrodesis Through a Fibular-Sparing Anterior Approach

et al. 2020

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Background: The open anterior approach to ankle arthrodesis offers a technique that provides several advantages for surgeons, such as easier visualization of the joint for deformity correction and preservation of the malleoli for potential future conversion to total ankle arthroplasty. The purpose of this study was to evaluate clinical, radiographic, and functional outcomes in a large series of patients undergoing open ankle arthrodesis via a fibular-sparing anterior approach. Methods: A retrospective review was performed of patients undergoing primary ankle arthrodesis with a single fellowship-trained foot and ankle orthopedic surgeon between 2009 and 2017. Patients were excluded if an approach other than anterior was performed. Patient-reported outcome measures (Foot and Ankle Ability Measure–Activities of Daily Living [FAAM-ADL], Short-Form 12 [SF-12], and visual analog scale [VAS] pain) were subsequently collected at a minimum of 24 months (2 years) following index surgery, along with outcome satisfaction and likelihood to repeat surgery. Fusion of the tibiotalar joint at the time of last radiographic follow-up was also assessed. Paired t tests were performed to assess change in pre- to postoperative outcomes, while linear regression analysis was performed to identify any patient factors associated with outcomes. Eighty-one patients, including 31 women and 50 men, with a mean age of 51.5 years and a mean follow-up of 58.9 (range, 24-104) months, were included. Results: Sixty-two patients reported significant improvement in mean FAAM-ADL ( P < .0001), SF-12 Physical Composite Scale ( P < .0001), and VAS pain ( P < .0001), while the SF-12 Mental Composite Scale also improved, though not significantly ( P = .2854). Twelve patients (14.8%) experienced complications following their arthrodesis procedure. Seventy-nine patients (97.5%) achieved fusion at their last radiographic follow-up. Multiple linear regression analysis revealed age ( B = 0.071 [0.004, 0.128]; P = .0373) to have a positive association with postoperative VAS pain. Conclusion: Ankle arthrodesis utilizing a fibular-sparing anterior approach combined with the transarticular screw fixation technique offers surgeons several advantages, along with a low postoperative complication rate, high rate of radiographic evidence of joint fusion, and substantially large improvement in pain and functional levels. Level of Evidence: Level IV, retrospective case series.

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“…9). In diesen Fällen bietet der Nagel biomechanisch Vorteile gegenüber den Schraubentechniken und benötigt im Vergleich zu den Plattentechniken kleinere Weichteilinzisionen [9,10,11].…”

Section: Nageltechnikenunclassified

Arthrodesen am Sprunggelenk und Rückfuß

Mückley

Klos

2010

Trauma Berufskrankh

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Tibiotalar Arthrodesis with the Tibial Compression Nail

Cited by 13 publications

References 11 publications

Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade

Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade

Ankle Arthrodesis Through a Fibular-Sparing Anterior Approach

Arthrodesen am Sprunggelenk und Rückfuß

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