Comparing the Results of Total Ankle Arthroplasty Vs Tibiotalar Fusion (Ankle Arthrodesis) in Patients with Ankle Osteoarthritis since 2006 to 2020- A Systematic Review.
Arch Bone Jt Surg
; 10(6): 470-479, 2022 Jun.
Article
em En
| MEDLINE
| ID: mdl-35928907
ABSTRACT
Background:
This study compares the outcomes of patients undergoing total ankle arthroplasty (TAA) and tibiotalar fusion (ankle arthrodesis) in patients with end-stage osteoarthritis. The primary outcome assessed was Patient Reported Outcome Measures (PROMS); secondary outcomes included the incidence of revision, re-operation, and complications.Methods:
A systematic review of studies examining the outcomes of patients undergoing TAA and/or tibiotalar fusion from 2006 to 2020 was conducted. Individual cohort studies and randomized control trials were included. Outcomes were assessed at two and five years.Results:
21 studies were included 16 arthroplasty (2,016 patients) and 5 arthrodesis (256 patients) studies. No significant difference in PROMS was evident two years post-surgery - American Orthopaedic Foot and Ankle Society (AOFAS) scores were 78.8 (95% CI-confidence interval 76.6-80.8; n=1548) and 80.8 (95% CI 80.1-81.5; n=206 patients) for the arthroplasty and arthrodesis groups respectively. Two years post-surgery the revision rates for the arthroplasty and arthrodesis groups were similar - 3.5% (n=9) and 3.7% (n=61) respectively (OR-odds ratio 1.05; 95% CI 0.51-2.13); however, the re-operation rate was 2.5 times higher for the arthroplasty group (12.2%) in comparison to the arthrodesis group (5.1%) (OR 2.57; 95% CI 1.43-4.62). Documented complications in the arthroplasty group were half those documented in the arthrodesis group two years post-surgery (OR 0.53; 95% CI 0.37-0.77). No arthrodesis studies were found which contained mean 5-year follow-up data within the study period.Conclusion:
Despite recent developments in TAA design, we found no clear evidence as to their superiority over ankle arthrodesis when considering patient outcomes two years postoperatively. However, this conclusion could be debatable in some types of patients such as diabetic patients, posttraumatic patients and patients with stiff hindfoot and midfoot.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Idioma:
En
Revista:
Arch Bone Jt Surg
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Reino Unido