scholarly journals Ankle distraction arthroplasty for the treatment of severe ankle arthritis

Medicine ◽  
2020 ◽  
Vol 99 (39) ◽  
pp. e22330
Author(s):  
Xiao-Ning Liu ◽  
Fei Chang ◽  
Han-Yang Zhang ◽  
Zhuan Zhong ◽  
Pan Xue ◽  
...  
Keyword(s):  
Ankle Arthritis ◽  
Distraction Arthroplasty

Treatment of ankle arthritis with distraction arthroplasty

2010 ◽  
Vol 21 (3) ◽  
pp. 229-232 ◽  
Author(s):  
Matt Harrison ◽  
Douglas Beaman
Keyword(s):  
Ankle Arthritis ◽  
Distraction Arthroplasty

scholarly journals Effectiveness of distal tibial osteotomy with distraction arthroplasty in varus ankle osteoarthritis

2019 ◽  
Author(s):  
Koji Nozaka ◽  
Naohisa Miyakoshi ◽  
Takeshi Kashiwagura ◽  
Yuji Kasukawa ◽  
Hidetomo Saito ◽  
...  
Keyword(s):  
Ankle Joint ◽  
External Fixator ◽  
Weight Bearing ◽  
Tibial Osteotomy ◽  
Ankle Arthritis ◽  
Ankle Osteoarthritis ◽  
Distraction Arthroplasty ◽  
Circular External Fixator ◽  
Joint Distraction ◽  
Tibiotalar Arthrodesis

Abstract Background: Advanced to end-stage ankle osteoarthritis in highly active older individuals has traditionally been treated using tibiotalar arthrodesis. With tibiotalar arthrodesis, high levels of pain-free function are possible; however, there is a loss of ankle joint movement and a risk of future arthrosis in the adjacent joints. Distraction arthroplasty is a simple method that allows joint cartilage repair; however, the results are currently mixed, with some reports showing improved pain scores and others showing no improvement. Distal tibial osteotomy (DTO) without fibular osteotomy, a type of joint preservation surgery, has garnered attention in recent years. However, to our knowledge, there are no reports on DTO with joint distraction using a circular external fixator. Therefore, the purpose of this study was to examine the effect of DTO with joint distraction using a circular external fixator on ankle osteoarthritis. Methods: A total of 21 patients with medial ankle arthritis were examined. Arthroscopic synovectomy and a microfracture procedure were performed. Subsequently, angled osteotomy and correction of the distal tibia were performed. After ankle conditions improved, stabilization of the ankle joint was performed. An external fixator was used in all patients. In addition, joint distraction of about 5.8 mm was performed. All patients were allowed full weight-bearing walking immediately after surgery. Results: The anteroposterior mortise angle during weight-bearing, lateral mortise angle during weight-bearing, and talar tilt angle and anterior translation of the talus on ankle stress radiography significantly improved (P < 0.05). In addition, signal changes on magnetic resonance imaging improved in all patients. Visual analogue scale and American Orthopedic Foot & Ankle Society scores also improved significantly (P < 0.05). No severe complications were observed. Conclusion: DTO with joint distraction may be useful for older patients with a high physical activity level as a joint-preserving surgery for medial ankle osteoarthritis. Level of evidence: Level IV, retrospective case series Key words : distal tibial osteotomy, medial ankle arthritis, joint distraction, circular external fixator

scholarly journals Effectiveness of distal tibial osteotomy with distraction arthroplasty in varus ankle osteoarthritis

2020 ◽  
Author(s):  
Koji Nozaka ◽  
Naohisa Miyakoshi ◽  
Takeshi Kashiwagura ◽  
Yuji Kasukawa ◽  
Hidetomo Saito ◽  
...  
Keyword(s):  
Ankle Joint ◽  
External Fixator ◽  
Weight Bearing ◽  
Tibial Osteotomy ◽  
Ankle Arthritis ◽  
Ankle Osteoarthritis ◽  
Distraction Arthroplasty ◽  
Circular External Fixator ◽  
Joint Distraction ◽  
Tibiotalar Arthrodesis

Abstract Background: Advanced to end-stage ankle osteoarthritis in highly active older individuals has traditionally been treated using tibiotalar arthrodesis. With tibiotalar arthrodesis, high levels of pain-free function are possible; however, there is a loss of ankle joint movement and a risk of future arthrosis in the adjacent joints. Distraction arthroplasty is a simple method that allows joint cartilage repair; however, the results are currently mixed, with some reports showing improved pain scores and others showing no improvement. Distal tibial osteotomy (DTO) without fibular osteotomy, a type of joint preservation surgery, has garnered attention in recent years. However, to our knowledge, there are no reports on DTO with joint distraction using a circular external fixator. Therefore, the purpose of this study was to examine the effect of DTO with joint distraction using a circular external fixator on ankle osteoarthritis. Methods: A total of 21 patients with medial ankle arthritis were examined. Arthroscopic synovectomy and a microfracture procedure were performed. Subsequently, angled osteotomy and correction of the distal tibia were performed. After ankle conditions improved, stabilization of the ankle joint was performed. An external fixator was used in all patients. In addition, joint distraction of about 5.8 mm was performed. All patients were allowed full weight-bearing walking immediately after surgery. Results: The anteroposterior mortise angle during weight-bearing, lateral mortise angle during weight-bearing, and talar tilt angle and anterior translation of the talus on ankle stress radiography significantly improved (P < 0.05). In addition, signal changes on magnetic resonance imaging improved in all patients. Visual analogue scale and American Orthopedic Foot & Ankle Society scores also improved significantly (P < 0.05). No severe complications were observed. Conclusion: DTO with joint distraction may be useful for older patients with a high physical activity level as a joint-preserving surgery for medial ankle osteoarthritis. Level of evidence: Level IV, retrospective case series Key words : distal tibial osteotomy, medial ankle arthritis, joint distraction, circular external fixator

Deformity Correction and Distraction Arthroplasty for Ankle Arthritis

2006 ◽  
Vol 5 (3) ◽  
pp. 134-143
Author(s):  
Douglas N. Beaman ◽  
Richard E. Gellman ◽  
Elly Trepman
Keyword(s):  
Deformity Correction ◽  
Ankle Arthritis ◽  
Distraction Arthroplasty

scholarly journals Clinical Outcomes of Ankle Distraction Arthroplasty Versus Supramalleolar Osteotomy

2021 ◽  
Author(s):  
Zongyu Yang ◽  
Liang Cui ◽  
Shiwu Tao ◽  
Li Wang ◽  
Fengqi Zhang ◽  
...  
Keyword(s):  
Young Patients ◽  
Ankle Arthritis ◽  
Level Of Evidence ◽  
Distraction Arthroplasty ◽  
Supramalleolar Osteotomy ◽  
Significant Difference ◽  
Post Traumatic ◽  
Improved Function ◽  
Surface Angle

Abstract BackgroundPost-traumatic ankle arthritis is increasing in young people and it is very important to preserve the ankle range of motion in young patients. This study aimed to compare ankle distraction arthroplasty versus supramalleolar osteotomy for post-traumatic ankle arthritis.MethodsThis retrospective study reviewed 32 consecutive patients who underwent surgery for post-traumatic ankle arthritis from January 2015 to December 2018 after failure of conservative treatment. Thirteen ankles that underwent ankle distraction arthroplasty were age-, sex-, and body mass index-matched with 19 ankles that underwent supramalleolar osteotomy. Patients returned for clinical and radiologic follow-up at an average of 32 (range, 24–48) months postoperatively. Outcomes were the comparison of the pre- and postoperative Visual Analog Scale (VAS) pain scores and American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores, complications, subjective patient-rated satisfaction, and ankle function.ResultsThe VAS and AOFAS scores of the two groups were significantly improved at final follow-up compared with preoperatively (p<0.05), but did not significantly differ between groups. The ankle distraction arthroplasty group had better postoperative ankle mobility than the supramalleolar osteotomy group. There was no significant difference between the two groups in the tibial anterior surface angle, talar tilt angle, tibial lateral surface angle, and other imaging parameters, but supramalleolar osteotomy was more effective in correcting the load-bearing line of the ankle and hindfoot. The complication rate was similar in both groupsConclusionsAnkle distraction arthroplasty and supramalleolar osteotomy both achieved good pain relief and improved function in patients with traumatic ankle arthritis.Level of evidence: Level III, retrospective comparative series.

scholarly journals SMOT with Medial Distraction Arthroplasty for Ankle Arthritis with Increased Talar Tilt: A Comparative Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0025
Author(s):  
Zhao Hong-Mou
Keyword(s):  
Functional Evaluation ◽  
Ankle Arthritis ◽  
Ankle Osteoarthritis ◽  
Aofas Score ◽  
Hindfoot Alignment ◽  
Distraction Arthroplasty ◽  
Talar Tilt ◽  
And Function ◽  
Varus Ankle Osteoarthritis

Category: Ankle Arthritis Introduction/Purpose: An increased preoperative talar tilt (TT) angle was reported to be positively correlated with treatment failure after supramalleolar osteotomy (SMOT) for varus ankle osteoarthritis. Distraction arthroplasty was reported to have the ability to correct increased TT angles. The purpose of the current study was to compare the outcomes between SMOT with and without medial distraction arthroplasty (MDA) in the treatment of varus ankle osteoarthritis with increased TT angles. Methods: We retrospectively reviewed the functional outcomes and radiological findings of 56 patients who underwent SMOT with or without MDA for varus ankle osteoarthritis with increased TT angles. The AOFAS ankle-hindfoot score and AOS scores were used for functional evaluation. The tibial anterior surface (TAS) angle, talar tilt (TT) angle, tibial medial malleolar (TMM) angle, talocrural (TC) angle, tibial lateral surface (TLS) angle, and hindfoot alignment (HFA) angle were evaluated preoperatively and at the time of the last follow-up. Results: In the SMOT group, the AOFAS score and AOS pain and function scores were significantly improved (P <0.01 for each) at a mean follow-up of 67.5 months. The TAS, TT, TC, TLS, and HFA angles were all significantly improved (P <0.01 for each). Similarly, in the SMOT with MDA group, the AOFAS score, AOS pain and function scores, and the TAS, TT, TC, TLS, and HFA angles were all significantly improved postoperatively (P <0.01 for each) at a mean follow-up of 37.8 months. When comparing the two groups, the postoperative TT angle was significantly smaller in the SMOT with MDA group (P = 0.03) than in the SMOT group. In addition, the failure rate of TT angle correction was significantly higher in the SMOT group (P = 0.02) than in the SMOT with MDA group. Conclusion: SMOT is a promising procedure for functional improvement and malalignment correction for varus ankle osteoarthritis, even in patients with increased talar tilt. SMOT with MDA is a effective method to correct the varus ankle OA with increased talar tilt.

scholarly journals Ankle Distraction Arthroplasty combined with PRP injection for Post-traumatic Ankle Arthritis

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0038
Author(s):  
Zhongmin Shi ◽  
Wenqi Gu
Keyword(s):  
Ankle Joint ◽  
Plantar Flexion ◽  
Functional Limitation ◽  
Ankle Arthrodesis ◽  
Ankle Arthritis ◽  
Distraction Arthroplasty ◽  
Post Traumatic ◽  
Pin Tract Infection ◽  
American Orthopaedic ◽  
Dorsal Extension

Category: Ankle Arthritis Introduction/Purpose: To summarize and evaluate the surgical technique and clinical outcome of ankle distraction arthroplasty with PRP injection for post-traumatic ankle arthritis. Methods: Totally 21 patients of post-traumatic ankle arthritis were treated at the department of orthopaedic surgery, Shanghai Sixth People’s Hospital. They were 13 males and 8 females with an average age of 32.5±6.2 years. The average course of disease were 14.0±2.8 months. After the failure of conservative management for at least 6 months, ankle distraction arthroplasty with PRP injection was performed in all patients. American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot score system and Visual Analogue Scale (VAS) system were used to evaluate the final overall outcome. The range of motion (ROM) of ankle joint and complications were also recorded. Results: Pin tract infection was occurred in two patients, who were cured by alcohol care. 18 patients were followed for an average 36 months. The post-operative AOFAS ankle and hindfoot score was improved from 46.2±7.7 to 79.2±11.6 (t=-14.58, P ＜0.05), while the VAS score was decreased from 6.6±1.1 to 1.8±2.0 (t=16.424, P＜0.0001). The dorsal extension of ankle joint was increased from 1.3±9.3° to 8.1±5.5° (t=-4.675, P＜0.0001) and the plantar flexion was improved from 14.4±6.8° to 26.9±7.3°(t=-7.919, P＜0.05). The radiograph manifested the progressive course of ankle arthritis in four patients, two of which were cured by a salvage ankle arthrodesis by consequence of a failure of conservative treatment for persistent pain and functional limitation. Conclusion: The ankle distraction arthroplasty is an effective ankle preserving surgery, which could relieve symptoms, improve functions and delay the course of post-traumatic ankle arthritis

scholarly journals Ankle distraction arthroplasty using the Ilizarov external fixation and arthroscopy: first clinical experience

2021 ◽  
Vol 27 (1) ◽  
pp. 92-96
Author(s):  
S.S. Leonchuk ◽  
◽  
L.A. Ostrovskikh ◽  
N.V. Sazonova ◽  
◽  
...  
Keyword(s):  
Exercise Therapy ◽  
Sport Injury ◽  
Surgical Intervention ◽  
Comprehensive Treatment ◽  
Ankle Arthritis ◽  
Distraction Arthroplasty ◽  
Ilizarov Apparatus ◽  
And Function ◽  
Combined Technique

We report a clinical case of a 27-year-old patient with posttraumatic painful ankle arthritis following sport injury treated with combined methods. The patient underwent ankle distraction arthroplasty with original Ilizarov apparatus and arthroscopic diagnosis and treatment of the ankle injury followed by the joint unloading and exercise therapy with frame on performed for 6 weeks at the Kurgan Ilizarov Center. The patient could improve pain relief and function at a long term following comprehensive treatment including surgical intervention, a course of physical procedures and exercise therapy. The combined technique can be used as an alternative treatment for patients with posttraumatic ankle arthritis.

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