Christopher J Traynor, Hui Zhang, Carissa C Dock, Rebecca Stone McGaver, J Chris Coetzee, Jeffrey D Seybold, Kayla J Seiffert, Paul M Cammack, Bryan D Den Hartog
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引用次数: 0
Abstract
Background: Total ankle arthroplasty (TAA) has continued to increase in popularity as a treatment for ankle arthritis. Despite popularity, continual updates to implant designs strive for improved outcomes which has led to different implant design changes including an extended-length tibial tray to offer more distal tibia cortical coverage. The purpose of this study was to compare radiographic findings (tibial component subsidence, tibial component loosening, heterotopic ossification [HO]) and patient-reported outcome measures (PROMs) between 2 age-, gender-, and body mass index-matched TAA groups.
Methods: This study was a retrospective review of TAA patients matched into 2 groups: group 1 patients received the extended tibial tray implant, and group 2 received the standard tibial tray implant. Pre- and postoperative lateral radiographs and PROMs (Veterans-RAND 12 [VR-12] Item Health Survey, Ankle Osteoarthritis Scale [AOS], visual analog scale [VAS], and patient satisfaction) were analyzed.
Results: Seventy-eight patients were allocated to each group. The mean age was 66.7 years in group 1 and 66.9 years in group 2, with a mean follow-up of 44.6 months and 50.7 months, respectively. There were no significant differences between the groups for pre- and postoperative PROMs. Group 1 had higher patient satisfaction with overall care (95.4 vs 89.8, P = .019). Radiographically, the rate of HO formation was significantly lower in group 1 (38.5% vs 62.8%, P < .001), and group 1 also had greater plantarflexion (P = .096) and significantly less dorsiflexion (P = .008).
Conclusion: Results appear to indicate that using TAA implants with an extended-length tibial tray is associated with more complete distal tibia cortical coverage, a numerically lower but statistically nonsignificant rate of tibial component subsidence, less heterotopic ossification formation, a trend toward greater postoperative plantarflexion, and higher patient satisfaction with overall care.
Level of evidence: Level III, retrospective cohort study.
背景：全踝关节置换术（TAA）作为一种治疗踝关节关节炎的方法越来越受欢迎。尽管受欢迎，但不断更新的植入物设计力求改善结果，这导致了不同的植入物设计变化，包括延长长度的胫骨托盘，以提供更多的胫骨远端皮质覆盖。本研究的目的是比较2个年龄、性别和体重指数匹配的TAA组的影像学表现（胫骨构件下沉、胫骨构件松动、异位骨化[HO]）和患者报告的结果测量（PROMs）。方法：本研究对TAA患者进行回顾性分析，将TAA患者分为两组：1组患者接受胫骨扩展托盘种植体，2组患者接受胫骨标准托盘种植体。分析术前和术后侧位x线片和PROMs （Veterans-RAND 12 [VR-12]项目健康调查、踝关节骨关节炎量表[AOS]、视觉模拟量表[VAS]和患者满意度）。结果：每组78例。1组患者平均年龄66.7岁，2组患者平均年龄66.9岁，平均随访时间分别为44.6个月和50.7个月。两组间术前和术后PROMs无显著差异。组1患者整体护理满意度较高（95.4 vs 89.8, P = 0.019）。影像学上，组1的HO形成率明显降低(38.5% vs 62.8%, P P =。096)，背屈明显减少（P = 0.008）。结论：结果似乎表明，使用TAA植入物与延长长度的胫骨托盘具有更完整的胫骨远端皮质覆盖，数字上较低但统计上不显著的胫骨成分下沉率，异位骨化形成较少，术后跖屈曲趋势更大，患者对整体护理的满意度更高。证据等级：III级，回顾性队列研究。
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