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The salto total ankle arthroplasty: Clinical and radiological outcomes at five years
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Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
fragment abutting against the fibula, whereas the dislocating tendons cause the bony avulsions in Classes II and III. Conclusions: Due to pathoanatomical differences, surgical approach and natural history of neglected lesions differ depending on size of the bony fleck. The SPR must not be incised in case of big Class III flecks. http://dx.doi.org/10.1016/j.fas.2017.07.378
290 Novel cost-effective technique: Surgical modification in chronic lateral ankle instability I. Sarhan 1,∗ , A. Waly 1 , T. el Gammal 2 1 2
Alexandria University-EGY, Egypt Heart of England, UK
Background: Ankle sprains are one of the most common sports injuries. A major problem accompanying ankle injury is the high rate of recurrence associated with chronic ankle instability. Anatomic reconstructions using the ruptured ends of the ligaments to restore stability have gained popularity. Ankle instability has led to early post-traumatic osteoarthritis Objectives: The study aims at evaluation of the results of the novel surgical technique as a cost-effective method in the treatment of lateral ankle instability. Study design & methods: Prospective study in surgical Treatment lateral ankle instability, it consisted of anatomic reconstruction of the lateral ligaments using trans osseous suturing and augmentation using polyester tape. The pateints were then assessed according to AOFAS with minimum six months follow-up. Results: The numbers of patients included in the study were 30 patients with chronic ankle instability. The mean age of the patients was 27 years. Male patients were 22, while females were 8 patients. The mean postoperative score (AOFAS) was 91.0 ± 6.03 and this was an excellent result. Average duration of follow up was 20 months. There were16 patients with excellent functional outcome (53%) and 14 patients had good results (47%). There were no complications faced in this reconstruction surgery. Conclusions: The addition of polyester tape augmentation to the anatomic reconstruction added to the good functional outcome(early rehabilitation). However long-term studies are needed to confirm the excellent result of this technique. http://dx.doi.org/10.1016/j.fas.2017.07.379
291 Patient reported disability of ankle, hindfoot, midfoot and hallux metatarsophalangeal arthritis M. Christian 1,∗ , S. Koenig 2 , N. O’Hara 3 , J. Campbell 1 , R. Cerrato 1 , C. Jeng 1 1 Institute for Foot and Ankle Reconstruction at Mercy Medical Center, United States 2 University of Maryland School of Medicine, United States 3 University of Maryland Department of Orthopaedics, United States
Introduction: There has been in increased interest in foot and ankle arthritis in the literature in recent years. There is little data explaining how much patient reported disability is associated with each type of isolated foot and ankle arthritis. The purpose of our
study was to use validated rating scales to compare the patient reported disability associated with ankle, hindfoot, midfoot, and hallux metatarsalphalangeal (MTP) arthritides. Methods: We retrospectively reviewed the FFI and SF-12 scores of patients who presented to a high volume orthopaedic foot and ankle practice between 2010 and 2016 with either ankle, hindfoot, midfoot or hallux MTP arthritis. We included ages 18–65 who underwent a surgical procedure for arthritis within 6 months. We excluded patients with co-morbidities known to affect disability scores. 214 FFI and 195 SF-12 were included. Results: SF-12 PCS for all patients with arthritis were significantly lower than age-based norms. Patients with ankle arthritis had the highest disability (FFI 46.5, SF-12 PCS 32.3). Patients with midfoot and hindfoot arthritis had intermediate disability (Midfoot FFI 34.9, SF-12 PCS 34.5; Hindfoot FFI 44.3, SF-12 PCS 34.5). Patients with MTP arthritis had the lowest disability (FFI 32.9, SF-12 PCS 40.7). All FFI and SF-12 PCS were statistically significant. Conclusion: All patients with foot and ankle arthritis had increased disability compared to US age-based norms. Patients with ankle arthritis experience the most disability and patients with hallux MTP arthritis experience the least disability of the isolated types of arthritis in orthopaedic foot and ankle. http://dx.doi.org/10.1016/j.fas.2017.07.380
292 The salto total ankle arthroplasty: Clinical and radiological outcomes at five years K. Koo 1,∗ , A. Liddle 2 , P. Pastides 2 , P. Rosenfeld 2 1 2
Singapore General Hospital, Singapore Imperial College Healthcare NHS Trust, Singapore
Introduction: Modern designs of total ankle arthroplasty (TAA) have the potential to treat symptomatic ankle osteoarthritis without adversely affecting ankle biomechanics. We present the mid-term results of a modern, mobile-bearing TAA design. Methods: TAA was performed in 50 consecutive patients (55 ankles) in an independent, prospective, single-centre series. Implant survival, patient-reported outcome measures (PROMs) and radiographic outcomes are presented at a mean of five years (range 2–10.5 years). Results: A total of three patients (four ankles) died and two (two ankles) were lost to follow-up. Three TAAs were revised for aseptic loosening (in two cases) or infection. Two further patients underwent reoperations, one for arthroscopic debridement of anterolateral synovitis and one for grafting of an asymptomatic tibial cyst. With all-cause revision as an endpoint, implant survival was 93.3% at five to ten years (95% CI 80.5%–97.8%). If reoperations are included this falls to 90.2% (95% CI 75.6%–96.3%) at five years. No other patient demonstrated radiographic evidence of loosening or subsidence. PROMs and satisfaction were excellent at latest follow-up. Conclusion: At five years, the outcomes for this design of TAA in this series were excellent, and were similar to those of previously published series from the designer centre. http://dx.doi.org/10.1016/j.fas.2017.07.381
Abstracts from the 6th IFFAS Triennial Meeting / Foot and Ankle Surgery 23(S1) (2017) 29–154
fragment abutting against the fibula, whereas the dislocating tendons cause the bony avulsions in Classes II and III. Conclusions: Due to pathoanatomical differences, surgical approach and natural history of neglected lesions differ depending on size of the bony fleck. The SPR must not be incised in case of big Class III flecks. http://dx.doi.org/10.1016/j.fas.2017.07.378
290 Novel cost-effective technique: Surgical modification in chronic lateral ankle instability I. Sarhan 1,∗ , A. Waly 1 , T. el Gammal 2 1 2
Alexandria University-EGY, Egypt Heart of England, UK
Background: Ankle sprains are one of the most common sports injuries. A major problem accompanying ankle injury is the high rate of recurrence associated with chronic ankle instability. Anatomic reconstructions using the ruptured ends of the ligaments to restore stability have gained popularity. Ankle instability has led to early post-traumatic osteoarthritis Objectives: The study aims at evaluation of the results of the novel surgical technique as a cost-effective method in the treatment of lateral ankle instability. Study design & methods: Prospective study in surgical Treatment lateral ankle instability, it consisted of anatomic reconstruction of the lateral ligaments using trans osseous suturing and augmentation using polyester tape. The pateints were then assessed according to AOFAS with minimum six months follow-up. Results: The numbers of patients included in the study were 30 patients with chronic ankle instability. The mean age of the patients was 27 years. Male patients were 22, while females were 8 patients. The mean postoperative score (AOFAS) was 91.0 ± 6.03 and this was an excellent result. Average duration of follow up was 20 months. There were16 patients with excellent functional outcome (53%) and 14 patients had good results (47%). There were no complications faced in this reconstruction surgery. Conclusions: The addition of polyester tape augmentation to the anatomic reconstruction added to the good functional outcome(early rehabilitation). However long-term studies are needed to confirm the excellent result of this technique. http://dx.doi.org/10.1016/j.fas.2017.07.379
291 Patient reported disability of ankle, hindfoot, midfoot and hallux metatarsophalangeal arthritis M. Christian 1,∗ , S. Koenig 2 , N. O’Hara 3 , J. Campbell 1 , R. Cerrato 1 , C. Jeng 1 1 Institute for Foot and Ankle Reconstruction at Mercy Medical Center, United States 2 University of Maryland School of Medicine, United States 3 University of Maryland Department of Orthopaedics, United States
Introduction: There has been in increased interest in foot and ankle arthritis in the literature in recent years. There is little data explaining how much patient reported disability is associated with each type of isolated foot and ankle arthritis. The purpose of our
study was to use validated rating scales to compare the patient reported disability associated with ankle, hindfoot, midfoot, and hallux metatarsalphalangeal (MTP) arthritides. Methods: We retrospectively reviewed the FFI and SF-12 scores of patients who presented to a high volume orthopaedic foot and ankle practice between 2010 and 2016 with either ankle, hindfoot, midfoot or hallux MTP arthritis. We included ages 18–65 who underwent a surgical procedure for arthritis within 6 months. We excluded patients with co-morbidities known to affect disability scores. 214 FFI and 195 SF-12 were included. Results: SF-12 PCS for all patients with arthritis were significantly lower than age-based norms. Patients with ankle arthritis had the highest disability (FFI 46.5, SF-12 PCS 32.3). Patients with midfoot and hindfoot arthritis had intermediate disability (Midfoot FFI 34.9, SF-12 PCS 34.5; Hindfoot FFI 44.3, SF-12 PCS 34.5). Patients with MTP arthritis had the lowest disability (FFI 32.9, SF-12 PCS 40.7). All FFI and SF-12 PCS were statistically significant. Conclusion: All patients with foot and ankle arthritis had increased disability compared to US age-based norms. Patients with ankle arthritis experience the most disability and patients with hallux MTP arthritis experience the least disability of the isolated types of arthritis in orthopaedic foot and ankle. http://dx.doi.org/10.1016/j.fas.2017.07.380
292 The salto total ankle arthroplasty: Clinical and radiological outcomes at five years K. Koo 1,∗ , A. Liddle 2 , P. Pastides 2 , P. Rosenfeld 2 1 2
Singapore General Hospital, Singapore Imperial College Healthcare NHS Trust, Singapore
Introduction: Modern designs of total ankle arthroplasty (TAA) have the potential to treat symptomatic ankle osteoarthritis without adversely affecting ankle biomechanics. We present the mid-term results of a modern, mobile-bearing TAA design. Methods: TAA was performed in 50 consecutive patients (55 ankles) in an independent, prospective, single-centre series. Implant survival, patient-reported outcome measures (PROMs) and radiographic outcomes are presented at a mean of five years (range 2–10.5 years). Results: A total of three patients (four ankles) died and two (two ankles) were lost to follow-up. Three TAAs were revised for aseptic loosening (in two cases) or infection. Two further patients underwent reoperations, one for arthroscopic debridement of anterolateral synovitis and one for grafting of an asymptomatic tibial cyst. With all-cause revision as an endpoint, implant survival was 93.3% at five to ten years (95% CI 80.5%–97.8%). If reoperations are included this falls to 90.2% (95% CI 75.6%–96.3%) at five years. No other patient demonstrated radiographic evidence of loosening or subsidence. PROMs and satisfaction were excellent at latest follow-up. Conclusion: At five years, the outcomes for this design of TAA in this series were excellent, and were similar to those of previously published series from the designer centre. http://dx.doi.org/10.1016/j.fas.2017.07.381