Preoperative Incongruent Subtalar Joint Predicts Less Favorable Clinical Outcome in Total Ankle Arthroplasty

Category: Ankle Arthritis; Hindfoot Introduction/Purpose: The clinical role of incongruent subtalar joints on ankle arthritis as well as that on the clinical outcome of surgical treatment such as total ankle arthroplasty (TAA) has not yet been fully understood. The mobile subtalar joint may compensa...

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Main Authors: Min Gyu Kyung MD, PhD, Jahyung Kim MD, Joonhee Kim MD, Hye Ran Lee, Ji Hye Kim, A Ro Yoon, Min Ju Kim, Dong Yeon Lee MD, PhD
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011424S00441
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author Min Gyu Kyung MD, PhD
Jahyung Kim MD
Joonhee Kim MD
Hye Ran Lee
Ji Hye Kim
A Ro Yoon
Min Ju Kim
Dong Yeon Lee MD, PhD
author_facet Min Gyu Kyung MD, PhD
Jahyung Kim MD
Joonhee Kim MD
Hye Ran Lee
Ji Hye Kim
A Ro Yoon
Min Ju Kim
Dong Yeon Lee MD, PhD
author_sort Min Gyu Kyung MD, PhD
collection DOAJ
description Category: Ankle Arthritis; Hindfoot Introduction/Purpose: The clinical role of incongruent subtalar joints on ankle arthritis as well as that on the clinical outcome of surgical treatment such as total ankle arthroplasty (TAA) has not yet been fully understood. The mobile subtalar joint may compensate for malalignment of the arthritic ankle as well as counteract the effect of realigning surgeries. We aimed to determine the clinical effect of incongruent subtalar joint space on TAA. Methods: We retrospectively reviewed 34 patients who underwent TAA, which were grouped according to the status of subtalar joint incongruency. For clinical parameters, American Orthopaedic Foot & Ankle Society (AOFAS) score and pain visual analog scale (VAS) were collected. For radiographic parameters, preoperative talar tilt angle, medial distal tibial angle, and anterior distal tibial angle were measured. A comparison of clinical and radiographic parameters between groups as well as multiple regression analysis was performed to identify contributing factors to the final functional outcome. Results: Interobserver and intraobserver reliabilities of subtalar joint congruency demonstrated substantial agreement. At the final follow-up, the AOFAS score was significantly higher in the congruent group (n=13) compared to that of the incongruent group (n=21), (90.38 vs. 79.57, p=0.007). However, there was no significant difference in pain VAS between the groups at the final follow-up (p=0.181). For measured radiographic parameters, there were no significant differences between the two groups in talar tilt angle, medial distal tibial angle, and anterior distal tibial angle. In multiple regression analysis, the female sex (p=0.006) and incongruency of the subtalar joint (p=0.013) were found to be significant contributing factors to the final AOFAS score. Conclusion: Patients in which the preoperative subtalar joint is incongruent showed less favorable AOFAS scores after undergoing TAA. A thorough preoperative investigation should be taken into the state of the subtalar joint for TAA.
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spelling doaj-art-0d5cbe8ab91d4ed1b5e7c6f1bb6b7d072024-12-27T12:05:03ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-12-01910.1177/2473011424S00441Preoperative Incongruent Subtalar Joint Predicts Less Favorable Clinical Outcome in Total Ankle ArthroplastyMin Gyu Kyung MD, PhDJahyung Kim MDJoonhee Kim MDHye Ran LeeJi Hye KimA Ro YoonMin Ju KimDong Yeon Lee MD, PhDCategory: Ankle Arthritis; Hindfoot Introduction/Purpose: The clinical role of incongruent subtalar joints on ankle arthritis as well as that on the clinical outcome of surgical treatment such as total ankle arthroplasty (TAA) has not yet been fully understood. The mobile subtalar joint may compensate for malalignment of the arthritic ankle as well as counteract the effect of realigning surgeries. We aimed to determine the clinical effect of incongruent subtalar joint space on TAA. Methods: We retrospectively reviewed 34 patients who underwent TAA, which were grouped according to the status of subtalar joint incongruency. For clinical parameters, American Orthopaedic Foot & Ankle Society (AOFAS) score and pain visual analog scale (VAS) were collected. For radiographic parameters, preoperative talar tilt angle, medial distal tibial angle, and anterior distal tibial angle were measured. A comparison of clinical and radiographic parameters between groups as well as multiple regression analysis was performed to identify contributing factors to the final functional outcome. Results: Interobserver and intraobserver reliabilities of subtalar joint congruency demonstrated substantial agreement. At the final follow-up, the AOFAS score was significantly higher in the congruent group (n=13) compared to that of the incongruent group (n=21), (90.38 vs. 79.57, p=0.007). However, there was no significant difference in pain VAS between the groups at the final follow-up (p=0.181). For measured radiographic parameters, there were no significant differences between the two groups in talar tilt angle, medial distal tibial angle, and anterior distal tibial angle. In multiple regression analysis, the female sex (p=0.006) and incongruency of the subtalar joint (p=0.013) were found to be significant contributing factors to the final AOFAS score. Conclusion: Patients in which the preoperative subtalar joint is incongruent showed less favorable AOFAS scores after undergoing TAA. A thorough preoperative investigation should be taken into the state of the subtalar joint for TAA.https://doi.org/10.1177/2473011424S00441
spellingShingle Min Gyu Kyung MD, PhD
Jahyung Kim MD
Joonhee Kim MD
Hye Ran Lee
Ji Hye Kim
A Ro Yoon
Min Ju Kim
Dong Yeon Lee MD, PhD
Preoperative Incongruent Subtalar Joint Predicts Less Favorable Clinical Outcome in Total Ankle Arthroplasty
Foot & Ankle Orthopaedics
title Preoperative Incongruent Subtalar Joint Predicts Less Favorable Clinical Outcome in Total Ankle Arthroplasty
title_full Preoperative Incongruent Subtalar Joint Predicts Less Favorable Clinical Outcome in Total Ankle Arthroplasty
title_fullStr Preoperative Incongruent Subtalar Joint Predicts Less Favorable Clinical Outcome in Total Ankle Arthroplasty
title_full_unstemmed Preoperative Incongruent Subtalar Joint Predicts Less Favorable Clinical Outcome in Total Ankle Arthroplasty
title_short Preoperative Incongruent Subtalar Joint Predicts Less Favorable Clinical Outcome in Total Ankle Arthroplasty
title_sort preoperative incongruent subtalar joint predicts less favorable clinical outcome in total ankle arthroplasty
url https://doi.org/10.1177/2473011424S00441
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