The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons · 2025
Comparison of factors influencing postoperative outcomes between total ankle arthroplasty and ankle arthrodesis in end-stage ankle arthritis.
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Hanada Mitsuru, Hotta Kensuke, Matsuyama Yukihiro
Аннотация
BACKGROUND: Total ankle arthroplasty (TAA) and ankle arthrodesis (AAD) are the established surgical options for end-stage ankle arthritis.
PURPOSE: This study aimed to compare the two procedures and to investigate factors associated with postoperative outcomes, including ankle range of motion (ROM) measured on lateral radiographs. ROM was assessed as the motion of the foot relative to the lower leg and was defined as the apparent ankle ROM (AROM).
METHODS: We retrospectively analyzed data from 38 patients who underwent TAA (n=18) or AAD (n=20) between 2015 and 2023. Patients with a minimum of 1-year follow-up were included in this study. Preoperative and postoperative evaluations included the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and AROM. Comparisons between groups were made using non-parametric tests.
RESULTS: Both groups showed significant postoperative improvements in the JSSF scores (p<0.001). The TAA group showed no significant change in AROM (p=0.093), whereas the AAD group showed a significant decrease in AROM (p=0.011). Postoperative AROM differed significantly between the groups. In the TAA group, postoperative JSSF scores correlated with age, and postoperative AROM correlated with preoperative AROM. In the AAD group, postoperative JSSF scores correlated with preoperative JSSF score and postoperative AROM.
CONCLUSION: Both TAA and AAD yielded favorable outcomes. The JSSF score following TAA was associated with age, whereas outcomes after AAD were more closely linked to the preoperative clinical status and postoperative AROM, highlighting the importance of adjacent joint mobility after surgery. The timing of surgery and rehabilitation strategies are essential for optimizing results.
PURPOSE: This study aimed to compare the two procedures and to investigate factors associated with postoperative outcomes, including ankle range of motion (ROM) measured on lateral radiographs. ROM was assessed as the motion of the foot relative to the lower leg and was defined as the apparent ankle ROM (AROM).
METHODS: We retrospectively analyzed data from 38 patients who underwent TAA (n=18) or AAD (n=20) between 2015 and 2023. Patients with a minimum of 1-year follow-up were included in this study. Preoperative and postoperative evaluations included the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and AROM. Comparisons between groups were made using non-parametric tests.
RESULTS: Both groups showed significant postoperative improvements in the JSSF scores (p<0.001). The TAA group showed no significant change in AROM (p=0.093), whereas the AAD group showed a significant decrease in AROM (p=0.011). Postoperative AROM differed significantly between the groups. In the TAA group, postoperative JSSF scores correlated with age, and postoperative AROM correlated with preoperative AROM. In the AAD group, postoperative JSSF scores correlated with preoperative JSSF score and postoperative AROM.
CONCLUSION: Both TAA and AAD yielded favorable outcomes. The JSSF score following TAA was associated with age, whereas outcomes after AAD were more closely linked to the preoperative clinical status and postoperative AROM, highlighting the importance of adjacent joint mobility after surgery. The timing of surgery and rehabilitation strategies are essential for optimizing results.