Partial Ankle Arthroplasty: Talus Resurfacing for Mild-to-Moderate Osteoarthritis and Talus Hemiarthroplasty for Complex Osteochondral Lesions.

IF 0.5 4区 医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-05-01 DOI:10.7547/22-017
Nik Žlak, Matic Kolar, Nedim Mujanović, Matej Drobnič
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Abstract

Background: We present prospective short-term results of a limited patient series treated with two innovative partial ankle arthroplasties: talar dome resurfacing for mild-to-moderate ankle osteoarthritis and talar shoulder hemiarthroplasty for chronic medial osteochondral lesions of the talus.

Methods: Eleven patients underwent talus resurfacing and six patients had talar hemiarthroplasty. The outcome was followed by patient-reported measures and by pursuing serious adverse events or implant failures over a 2-year period. Progression of ankle osteoarthritis, peri-implant bone changes, and implant migration were followed radiographically.

Results: Active dorsiflexion increased from 3° to 10° in resurfacing and from 15° to 22° in hemiarthroplasty. Patient-reported ankle function, quality of life, and activity level tended to improve only slightly after resurfacing (cumulative Foot and Ankle Outcome Score, from 41 to 42; Foot and Ankle Ability Measures for daily activities [FAAM-ADL], from 43 to 46; EQ-5D-3L time trade-off, from 0.38 to 0.39; Tegner activity scale score, from 1.6 to 2.0) but moderately after hemiarthroplasty (cumulative Foot and Ankle Outcome Score, from 58 to 68; FAAM-ADL, from 37 to 71; EQ-5D-3L time trade-off, from 0.53 to 0.72; Tegner activity scale score, from 3.1 to 3.1). No implant-related radiographic changes, implant failures, or implant-related revision surgeries were recorded.

Conclusions: Based on a small and heterogeneous prospective case series, both partial ankle implants investigated were safe and stable over 2-year follow-up, without any radiographic osteoarthritis progression of the remaining joint. However, patient-reported ankle function, quality of life, and activity level showed a tendency toward only minor improvement after resurfacing but a moderate increase after hemiarthroplasty.

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部分踝关节置换术:治疗轻度至中度骨关节炎的距骨再植术和治疗复杂骨软骨损伤的距骨半关节成形术。
背景:我们展示了采用两种创新性部分踝关节置换术治疗的有限患者系列的前瞻性短期结果:距骨穹隆再植术治疗轻度至中度踝关节骨关节炎,距骨肩关节半关节置换术治疗慢性距骨内侧骨软骨损伤:11名患者接受了距骨再植术,6名患者接受了距骨半关节成形术。在两年的时间里,通过患者报告的方法和严重不良事件或植入失败的追踪,对结果进行了跟踪。对踝关节骨关节炎的进展、假体周围骨质变化和假体移位进行了影像学跟踪:结果:活动外翻从3°增加到10°,半关节成形术从15°增加到22°。患者报告的踝关节功能、生活质量和活动水平在再植后仅略有改善(累积足踝结果评分从41分提高到42分;足踝日常活动能力测量[FAAM-ADL]从43分提高到46分;EQ-5D-3L时间权衡从0.38到0.39;Tegner活动量表评分从1.6到2.0),但在半关节成形术后情况有所改善(累积足踝结果评分从58到68;FAAM-ADL从37到71;EQ-5D-3L时间权衡从0.53到0.72;Tegner活动量表评分从3.1到3.1)。没有记录到与种植体相关的放射学变化、种植体失败或与种植体相关的翻修手术:基于一个小型和异质性的前瞻性病例系列,所研究的两种踝关节部分植入物在2年的随访中都是安全和稳定的,剩余关节没有出现任何放射性骨关节炎进展。然而,患者报告的踝关节功能、生活质量和活动水平显示,重置术后仅有轻微改善,而半关节成形术后则有适度改善。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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