Abstract
Category:
Ankle Arthritis
Introduction/Purpose:
This study aimed to evaluate the clinical and radiological results of total ankle arthroplasty, performed in ankle arthritis patients with varus deformity, according to the rotation and displacement types.
Methods:
Among the patients who had undergone total ankle arthroplasty using Hintegra, a 3-part prosthesis for end-stage ankle arthritis, 44 cases that were followed up for at least 1 year were included in this study. The patients were classified into either rotation or displacement type, and the clinical and radiological results of each group were analyzed. For clinical evaluation, the VAS and AOFAS ankle-hindfoot scale were used. Radiological evaluation was measured by using mechanical axis deviation (MAD), medial distal tibial angle (MDTA), talar tilt angle, tibiotalar angle (TTA), talus center migration (TCM), tibia-talar ratio (TTR), anterior distal tibial angle (ADTA) and hindfoot alignment angle (HAA).
Results:
Of the 44 cases, both the rotation and the displacement types were 22 cases each. VAS improved from 6.0±1.4 points and 6.0±1.5 points in each group before surgery to 2.0±0.9 points and 0.0±0.8 points at the final follow-up, showing a significant difference between the two groups (p < 0.001). The AOFAS scale improved from 59.5±11.0 points and 50.0±15.1 points in each group to 80.0±11.9 points and 97.0±8.0 points at the final follow-up, and the difference between the two groups was statistically significant (p=0.003). Most of the radiological indicators in each group were significantly improved. TCM was changed from 1.4±2.5mm and 6.7±2.6mm in each group before surgery to 0.8±2.2mm and 3.4±1.3mm at the last follow-up, and there was a significant difference in the displacement group (p < 0.001).
Conclusion:
Clinical and radiological improvements were obtained after total ankle arthroplasty, regardless of the deformity type. Displacement-type strains showed better clinical measures than rotational strains. The more normal the alignment of the hindfoot was, the better the clinical scale was. In patients with end-stage arthritis accompanied by medial displacement of the center of the talus, efforts to restore the normal alignment are needed.