Effect of Distraction Arthroplasty in the Treatment of Moderate‐to‐Severe Ankle Arthritis

Objective Currently, the traditional treatment of moderate‐to‐severe ankle arthritis is joint fusion or joint replacement. The aim of this article is to explore the clinical efficacy of distraction arthroplasty in the treatment of moderate‐to‐severe ankle arthritis. Methods A retrospective analysis...

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Main Authors: Jian Wang, Chenhan Wang, Xiaoheng Ding, Quanyu Dong
Format: Article
Language:English
Published: Wiley 2024-09-01
Series:Orthopaedic Surgery
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Online Access:https://doi.org/10.1111/os.14233
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author Jian Wang
Chenhan Wang
Xiaoheng Ding
Quanyu Dong
author_facet Jian Wang
Chenhan Wang
Xiaoheng Ding
Quanyu Dong
author_sort Jian Wang
collection DOAJ
description Objective Currently, the traditional treatment of moderate‐to‐severe ankle arthritis is joint fusion or joint replacement. The aim of this article is to explore the clinical efficacy of distraction arthroplasty in the treatment of moderate‐to‐severe ankle arthritis. Methods A retrospective analysis was conducted with a total of 34 cases who were diagnosed with moderate‐to‐severe ankle arthritis and treated by distraction arthroplasty from January 2007 to November 2021. The average age was 42.3 years. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle–hindfoot score and pain visual analog scale (VAS) were used to evaluate ankle pain and functional improvement before surgery and at the last follow‐up. Based on age, the patients were divided into the ≤45‐year‐old group [young group, 15 cases, age (36.37 ± 4.31) years old] and the >45‐year‐old group [middle‐aged and elderly group, 19 cases, age (53.74 ± 3.17) years old]. The analysis included comparing preoperative and postoperative AOFAS ankle–hindfoot and VAS scores and the influence of age on distraction arthroplasty. Results All 34 patients were followed up, and the follow‐up time ranged from 13 to 143 months, with an average of 45.3 months. The follow‐up times for the young and middle‐to‐elderly groups were (33.19 ± 21.37) months and (55.63 ± 29.69) months, respectively. At the last follow‐up, the AOFAS ankle–hindfoot and VAS scores were significantly improved compared with the preoperative assessment (p < 0.05). According to the etiological analysis, except for Pilon fracture, which showed no differences pre‐ and postoperation in the AOFAS ankle–hindfoot score and VAS score (p > 0.05), all other patients showed significant differences in these two scores (p < 0.05). The difference in preoperative AOFAS ankle–hindfoot scores between the young and middle‐to‐elderly groups was statistically significant (t = 3.422, p = 0.021). The preoperative and postoperative comparison of preoperative VAS scores, AOFAS ankle–hindfoot scores, and VAS scores before and after surgery showed no differences (p > 0.05). The joint space width (JSW) of 10 patients who were followed up for more than 5 years was (2.9 ± 0.5) mm. Two patients who were followed up for more than 10 years showed 3.3 and 3.0 mm, respectively, JSW. Conclusion Distraction arthroplasty with the Ilizarov external fixator can achieve satisfactory results in the treatment of moderate‐to‐severe ankle arthritis (except arthritis caused by Pilon fracture surgery). Age has no statistical impact on the efficacy of distraction arthroplasty.
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spelling doaj-art-4e99e2414f714a29af4a50cd2fa4d91f2024-11-18T16:42:18ZengWileyOrthopaedic Surgery1757-78531757-78612024-09-011692167217210.1111/os.14233Effect of Distraction Arthroplasty in the Treatment of Moderate‐to‐Severe Ankle ArthritisJian Wang0Chenhan Wang1Xiaoheng Ding2Quanyu Dong3Department of Hand, Foot and Microsurgery The Affiliated Hospital of Qingdao University Qingdao City ChinaDepartment of Hand, Foot and Microsurgery The Affiliated Hospital of Qingdao University Qingdao City ChinaDepartment of Hand, Foot and Microsurgery The Affiliated Hospital of Qingdao University Qingdao City ChinaDepartment of Hand, Foot and Microsurgery The Affiliated Hospital of Qingdao University Qingdao City ChinaObjective Currently, the traditional treatment of moderate‐to‐severe ankle arthritis is joint fusion or joint replacement. The aim of this article is to explore the clinical efficacy of distraction arthroplasty in the treatment of moderate‐to‐severe ankle arthritis. Methods A retrospective analysis was conducted with a total of 34 cases who were diagnosed with moderate‐to‐severe ankle arthritis and treated by distraction arthroplasty from January 2007 to November 2021. The average age was 42.3 years. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle–hindfoot score and pain visual analog scale (VAS) were used to evaluate ankle pain and functional improvement before surgery and at the last follow‐up. Based on age, the patients were divided into the ≤45‐year‐old group [young group, 15 cases, age (36.37 ± 4.31) years old] and the >45‐year‐old group [middle‐aged and elderly group, 19 cases, age (53.74 ± 3.17) years old]. The analysis included comparing preoperative and postoperative AOFAS ankle–hindfoot and VAS scores and the influence of age on distraction arthroplasty. Results All 34 patients were followed up, and the follow‐up time ranged from 13 to 143 months, with an average of 45.3 months. The follow‐up times for the young and middle‐to‐elderly groups were (33.19 ± 21.37) months and (55.63 ± 29.69) months, respectively. At the last follow‐up, the AOFAS ankle–hindfoot and VAS scores were significantly improved compared with the preoperative assessment (p < 0.05). According to the etiological analysis, except for Pilon fracture, which showed no differences pre‐ and postoperation in the AOFAS ankle–hindfoot score and VAS score (p > 0.05), all other patients showed significant differences in these two scores (p < 0.05). The difference in preoperative AOFAS ankle–hindfoot scores between the young and middle‐to‐elderly groups was statistically significant (t = 3.422, p = 0.021). The preoperative and postoperative comparison of preoperative VAS scores, AOFAS ankle–hindfoot scores, and VAS scores before and after surgery showed no differences (p > 0.05). The joint space width (JSW) of 10 patients who were followed up for more than 5 years was (2.9 ± 0.5) mm. Two patients who were followed up for more than 10 years showed 3.3 and 3.0 mm, respectively, JSW. Conclusion Distraction arthroplasty with the Ilizarov external fixator can achieve satisfactory results in the treatment of moderate‐to‐severe ankle arthritis (except arthritis caused by Pilon fracture surgery). Age has no statistical impact on the efficacy of distraction arthroplasty.https://doi.org/10.1111/os.14233Ankle ArthritisDistraction ArthroplastyExternal Fixator
spellingShingle Jian Wang
Chenhan Wang
Xiaoheng Ding
Quanyu Dong
Effect of Distraction Arthroplasty in the Treatment of Moderate‐to‐Severe Ankle Arthritis
Orthopaedic Surgery
Ankle Arthritis
Distraction Arthroplasty
External Fixator
title Effect of Distraction Arthroplasty in the Treatment of Moderate‐to‐Severe Ankle Arthritis
title_full Effect of Distraction Arthroplasty in the Treatment of Moderate‐to‐Severe Ankle Arthritis
title_fullStr Effect of Distraction Arthroplasty in the Treatment of Moderate‐to‐Severe Ankle Arthritis
title_full_unstemmed Effect of Distraction Arthroplasty in the Treatment of Moderate‐to‐Severe Ankle Arthritis
title_short Effect of Distraction Arthroplasty in the Treatment of Moderate‐to‐Severe Ankle Arthritis
title_sort effect of distraction arthroplasty in the treatment of moderate to severe ankle arthritis
topic Ankle Arthritis
Distraction Arthroplasty
External Fixator
url https://doi.org/10.1111/os.14233
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AT chenhanwang effectofdistractionarthroplastyinthetreatmentofmoderatetosevereanklearthritis
AT xiaohengding effectofdistractionarthroplastyinthetreatmentofmoderatetosevereanklearthritis
AT quanyudong effectofdistractionarthroplastyinthetreatmentofmoderatetosevereanklearthritis