Comparación de resultados clínico-radiológicos entre prótesis total y artrodesis de tobillo para el tratamiento de la artrosis postraumática

Abstract

Introduction

Ankle arthrodesis constitutes the gold standard for the treatment of postraumatic ankle osteoarthritis. Total ankle replacement has been developed as an alternative surgical option with motion preserving advantage. However, relative benefits of ankle replacement remain unclear. The objective of this study was to compare clinical, radiological results and complication rates in patients with postraumatic ankle osteoarthritis treated with arthrodesis and ankle replacement.

Material and methods

A retrospective study was made between 2007-2013 with postraumatic ankle osteoarthritis treated with ankle replacement (group 1) and ankle arthrodesis (group 2). Patients between 18-75 years with a minimum follow-up of 2 years were included. Neurological conditions, infections, rheumatic disease and previous ankle and mid-foot surgery were excluded. Varus-valgus correction, adjacent degenerative disease, reoperation rate and clinical evaluation (AOFAS and visual analoge scale) were evaluated.

Results

A total of 63 patients with (average age of 50) with 66 months follow-up were involved. There was no difference in terms of reoperation rate (P=.44) neither adjacent osteoarthritis (P=.62).

Varus-valgus preoperative and postoperative was 5.92 and 2.51 respectively (P=.0053) in group 1, 13.59 and 5.39 (P=.0002) in group 2. AOFAS score was 88 in group 1 and 92 in group 2. The visual analoge scale score was 4 in group 1 and 2.5 in group 2.

Conclusion

Ankle replacement resulted in similar varus-valgus correction, adjacent degenerative disease, complication rate and functional results compared with arthrodesis in our study. Ankle replacement could be a suitable surgical option for the treatment of postraumatic ankle osteoarthritis.