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Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis.

dc.contributor.author Lewis, John S
dc.contributor.author Adams, Samuel B
dc.contributor.author Queen, Robin M
dc.contributor.author DeOrio, James K
dc.contributor.author Nunley, James A
dc.contributor.author Easley, Mark E
dc.coverage.spatial United States
dc.date.accessioned 2014-06-20T02:03:22Z
dc.date.issued 2014-06
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/24677216
dc.identifier 1071100714528495
dc.identifier.uri https://hdl.handle.net/10161/8902
dc.description.abstract BACKGROUND: Ipsilateral hindfoot arthrodesis in combination with total ankle replacement (TAR) may diminish functional outcome and prosthesis survivorship compared to isolated TAR. We compared the outcome of isolated TAR to outcomes of TAR with ipsilateral hindfoot arthrodesis. METHODS: In a consecutive series of 404 primary TARs in 396 patients, 70 patients (17.3%) had a hindfoot fusion before, after, or at the time of TAR; the majority had either an isolated subtalar arthrodesis (n = 43, 62%) or triple arthrodesis (n = 15, 21%). The remaining 334 isolated TARs served as the control group. Mean patient follow-up was 3.2 years (range, 24-72 months). RESULTS: The SF-36 total, AOFAS Hindfoot-Ankle pain subscale, Foot and Ankle Disability Index, and Short Musculoskeletal Function Assessment scores were significantly improved from preoperative measures, with no significant differences between the hindfoot arthrodesis and control groups. The AOFAS Hindfoot-Ankle total, function, and alignment scores were significantly improved for both groups, albeit the control group demonstrated significantly higher scores in all 3 scales. Furthermore, the control group demonstrated a significantly greater improvement in VAS pain score compared to the hindfoot arthrodesis group. Walking speed, sit-to-stand time, and 4-square step test time were significantly improved for both groups at each postoperative time point; however, the hindfoot arthrodesis group completed these tests significantly slower than the control group. There was no significant difference in terms of talar component subsidence between the fusion (2.6 mm) and control groups (2.0 mm). The failure rate in the hindfoot fusion group (10.0%) was significantly higher than that in the control group (2.4%; p < 0.05). CONCLUSION: To our knowledge, this study represents the first series evaluating the clinical outcome of TARs performed with and without hindfoot fusion using implants available in the United States. At follow-up of 3.2 years, TAR performed with ipsilateral hindfoot arthrodesis resulted in significant improvements in pain and functional outcome; in contrast to prior studies, however, overall outcome was inferior to that of isolated TAR. LEVEL OF EVIDENCE: Level II, prospective comparative series.
dc.language eng
dc.publisher SAGE Publications
dc.relation.ispartof Foot Ankle Int
dc.relation.isversionof 10.1177/1071100714528495
dc.subject arthritis
dc.subject hindfoot arthrodesis
dc.subject total ankle replacement
dc.title Outcomes After Total Ankle Replacement in Association With Ipsilateral Hindfoot Arthrodesis.
dc.type Journal article
duke.contributor.id Lewis, John S|0287248
duke.contributor.id Adams, Samuel B|0327198
duke.contributor.id Queen, Robin M|0333217
duke.contributor.id DeOrio, James K|0418160
duke.contributor.id Nunley, James A|0101376
duke.contributor.id Easley, Mark E|0231818
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/24677216
pubs.begin-page 535
pubs.end-page 542
pubs.issue 6
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Faculty
pubs.organisational-group Orthopaedics
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 35
dc.identifier.eissn 1944-7876
duke.contributor.orcid DeOrio, James K|0000-0001-5181-9049


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