Total Ankle Replacement Versus Arthrodesis for End-Stage Ankle Osteoarthritis

Goldberg, Andy; Chowdhury, Kashfia; Bordea, Ekaterina; Hauptmannova, Iva; Blackstone, James; Brooking, Deirdre; Deane, Elizabeth L.; Bendall, Stephen; Bing, Andrew; Blundell, Chris; Dhar, Sunil; Molloy, Andy; Milner, S.; Karski, Mike; Hepple, S.; Siddique, Malik; Loveday, David; Mishra, Viren; Cooke, Paul; Halliwell, Paul; Townshend, David; Skene, Simon; Doré, Caroline J

doi:10.7326/m22-2058

Cited by 44 publications

(27 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, King et al 28 reported improvements in both HRQoL assessed with the EQ-5D-5L and clinical outcomes with the MOXFQ for a cohort of 20 patients two years after TAA. The OARS study was conducted contemporaneously with a randomized clinical trial of ankle arthroplasty compared with fusion (the TARVA trial) 11 at similar sites. OARS was designed as an observational study, with broader selection criteria from a wider base, and is more reflective of real-world clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…The study was performed contemporaneously with the total ankle replacement versus arthrodesis (TARVA) trial, which investigated clinical outcomes of TAA to ankle fusion. 11 This paper reports the data on 238 participants recruited to OARS solely, excluding 39 participants who were recruited into both OARS and TARVA. Data collection.…”

Section: Table I Continuedmentioning

confidence: 99%

“…[8][9][10] However, the available data from studies investigating patient-reported outcome measures (PROMs) following TAA are typically underpowered, based on limited follow-up, or derived from clinical trials conducted in selected groups. 11 There are currently no comprehensive data on patient outcomes following TAA from unselected populations to help guide patient and surgeon choice.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes in Ankle Replacement Study (OARS)

Smith,

Dainty,

Loveday

et al. 2023

Bone Joint J

Self Cite

View full text Add to dashboard Cite

AimsThe aim of this study was to capture 12-month outcomes from a representative multicentre cohort of patients undergoing total ankle arthroplasty (TAA), describe the pattern of patient-reported outcome measures (PROMs) at 12 months, and identify predictors of these outcome measures.MethodsPatients listed for a primary TAA at 19 NHS hospitals between February 2016 and October 2017 were eligible. PROMs data were collected preoperatively and at six and 12 months including: Manchester-Oxford Foot and Ankle Questionnaire (MOXFQ (foot and ankle)) and the EuroQol five-dimension five-level questionnaire (EQ-5D-5L). Radiological pre- and postoperative data included Kellgren-Lawrence score and implant position measurement. This was supplemented by data from the National Joint Registry through record linkage to determine: American Society of Anesthesiologists (ASA) grade at index procedure; indication for surgery, index ankle previous fracture; tibial hind foot alignment; additional surgery at the time of TAA; and implant type. Multivariate regression models assessed outcomes, and the relationship between MOXFQ and EQ-5D-5L outcomes, with patient characteristics.ResultsData from 238 patients were analyzed. There were significant improvements in MOXFQ and EQ-5D-5L among people who underwent TAA at six- and 12-month assessments compared with preoperative scores (p < 0.001). Most improvement occurred between preoperative and six months, with little further improvement at 12 months. A greater improvement in MOXFQ outcome postoperatively was associated with older age and more advanced radiological signs of ankle osteoarthritis at baseline.ConclusionTAA significantly benefits patients with end-stage ankle disease. The lack of substantial further overall change between six and 12 months suggests that capturing PROMs at six months is sufficient to assess the success of the procedure. Older patients and those with advanced radiological disease had the greater gains. These outcome predictors can be used to counsel younger patients and those with earlier ankle disease on the expectations of TAA.Cite this article: Bone Joint J 2023;105-B(8):895–904.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Table I Continuedmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes in Ankle Replacement Study (OARS)

Smith,

Dainty,

Loveday

et al. 2023

Bone Joint J

Self Cite

View full text Add to dashboard Cite

show abstract

“…Eligible patients were those with end-stage ankle osteoarthritis, aged 50 to 85 years, who the treating surgeon believed to be suitable for either TAA or AF. 4 There were 33 surgeons in the trial, and all surgeons had adequate experience and training and had undertaken a minimum of 20 independent procedures. A total of 152 patients were randomly assigned to TAA and 151 to AF.…”

Section: Total Ankle Arthroplasty Versus Arthrodesis For End-stage An...mentioning

confidence: 99%

Foot & Ankle

2023

Bone &Amp; Joint 360

View full text Add to dashboard Cite

The April 2023 Foot & Ankle Roundup360 looks at: Outcomes following a two-stage revision total ankle arthroplasty for periprosthetic joint infection; Temporary bridge plate fixation and joint motion after an unstable Lisfranc injury; Outcomes of fusion in type II os naviculare; Total ankle arthroplasty versus arthrodesis for end-stage ankle osteoarthritis; Normal saline for plantar fasciitis: placebo or therapeutic?; Distraction arthroplasty for ankle osteoarthritis: does it work?; Let there be movement: ankle arthroplasty after previous fusion; Morbidity and mortality after diabetic Charcot foot arthropathy.

show abstract

“…Compared with the knee, hip, or shoulder, the ankle is a remarkably constrained joint surrounded by a complex of hindfoot joints capable of adapting to lack of ankle motion. Indeed, clear benefits for ankle replacement over ankle fusion have been difficult to elucidate and are still not evident in patient-reported outcomes from the one high-quality randomized controlled trial comparing the procedures [7]. The ankle is more amenable to bracing than other lower extremity joints, and some patients may find their own coping strategies by using work boots or high-top shoes long before they decide to come to the orthopaedist’s office.…”

Section: Where Are We Now?mentioning

confidence: 99%

CORR Insights®: What Is the Efficacy of Intra-articular Injections in the Treatment of Ankle Osteoarthritis? A Systematic Review

Guyton

2023

Clin Orthop Relat Res

View full text Add to dashboard Cite

Total Ankle Replacement Versus Arthrodesis for End-Stage Ankle Osteoarthritis

Cited by 44 publications

References 25 publications

Outcomes in Ankle Replacement Study (OARS)

Outcomes in Ankle Replacement Study (OARS)

Foot & Ankle

CORR Insights®: What Is the Efficacy of Intra-articular Injections in the Treatment of Ankle Osteoarthritis? A Systematic Review

Contact Info

Product

Resources

About