Heterotopic ossifications in anterior and lateral approach total ankle replacement: A retrospective evaluation.

IF 1.3 4区 医学 Q2 Medicine
Giammarco Gardini, Silvio Caravelli, Carlo Capodagli, Giulio Vara, Stefano Ratti, Marco Di Ponte, Massimiliano Mosca
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引用次数: 0

Abstract

Heterotopic periarticular ossifications (HO) are a frequent short to mid-term complication following Total Ankle Replacement (TAR). Historically two primary surgical approaches exist-Lateral Approach (LA) and Anterior Approach (AA)-each bound with different prosthetic designs. However, there is no consensus on the incidence, real clinical impact, or need for reintervention of HO between these approaches, nor on the necessity of prophylactic treatments. This retrospective, monocentric, comparative study (evidence level III) involved radiological classification of patients using the modified Brooker Classification System (mBCS) by two independent orthopedic surgeons. A total of 105 patients undergoing LA or AA TAR at the same center were included. Radiographic HO was observed in 84 patients (80 %). Of these, 19 (23 %) required surgical intervention due to symptomatic HO. In the AA group (62 patients, Vantage Exactech prosthesis), 45 (73 %) developed HO, with 10 having sufficient symptoms which were treated with arthrolysis. In the LA group (43 patients, Trabecular Metal Zimmer prosthesis), 39 (91 %) developed HO, with 9 requiring arthrolysis. HO was more prevalent in the LA group than in the AA group (91 % vs. 73 %). A direct correlation was found between clinical scores (FAAM and Pain Score) and HO severity. Prosthesis with LA more frequently develop HO than AA. In addition, young patients, delayed ankle mobilization and weightbearing can be accounted as risk factors in the development of HOs; conversely smoking, BMI, duration of surgery and post-traumatic arthritis were not found to have a significant impact.

前路和外侧入路全踝关节置换术中的异位骨化:回顾性评价。
异位关节周围骨化(HO)是全踝关节置换术(TAR)后常见的中短期并发症。历史上存在两种主要的手术入路-外侧入路(LA)和前路(AA)-每种入路都有不同的假体设计。然而,对于这些方法之间的发病率、实际临床影响或再干预的必要性,以及预防性治疗的必要性,目前尚无共识。这项回顾性、单中心、比较研究(证据水平III)涉及两位独立骨科医生使用改良的Brooker分类系统(mBCS)对患者进行放射学分类。共纳入105例在同一中心接受LA或AA TAR的患者。84例(80%)患者出现影像学上的HO。其中19例(23%)因症状性HO需要手术干预。在AA组(62例患者,Vantage Exactech假体)中,45例(73%)发生HO,其中10例有足够的症状,并进行了关节松解治疗。在LA组(43例患者,使用金属小梁假体)中,39例(91%)发生HO,其中9例需要关节松解。HO在LA组比AA组更普遍(91%对73%)。临床评分(FAAM和Pain Score)与HO严重程度之间存在直接相关性。LA假体比AA假体更容易发生HO。此外,年轻患者、踝关节活动迟缓和负重可被认为是HOs发生的危险因素;相反,吸烟、身体质量指数、手术时间和创伤后关节炎并没有明显的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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