Giammarco Gardini, Silvio Caravelli, Carlo Capodagli, Giulio Vara, Stefano Ratti, Marco Di Ponte, Massimiliano Mosca
{"title":"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。","authors":"Giammarco Gardini, Silvio Caravelli, Carlo Capodagli, Giulio Vara, Stefano Ratti, Marco Di Ponte, Massimiliano Mosca","doi":"10.1053/j.jfas.2025.08.001","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Heterotopic ossifications in anterior and lateral approach total ankle replacement: A retrospective evaluation.\",\"authors\":\"Giammarco Gardini, Silvio Caravelli, Carlo Capodagli, Giulio Vara, Stefano Ratti, Marco Di Ponte, Massimiliano Mosca\",\"doi\":\"10.1053/j.jfas.2025.08.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":50191,\"journal\":{\"name\":\"Journal of Foot & Ankle Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-08-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Foot & Ankle Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1053/j.jfas.2025.08.001\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Foot & Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1053/j.jfas.2025.08.001","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Heterotopic ossifications in anterior and lateral approach total ankle replacement: A retrospective evaluation.
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.
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.