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Clinical-radiological outcomes and complications after total ankle replacement through a lateral transfibular approach: a retrospective evaluation at a mid-term follow-up

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Abstract

Purpose

Degenerative ankle arthropathy is a debilitating and increasingly widespread condition with worsening of quality of life. In last years, total ankle replacement has increased indications, thanks to advances in surgical technique, materials and design that provided new solutions for surgeons. The purpose of this study is to evaluate the effectiveness of total ankle replacement (TAR), implanted using a trans-fibular lateral approach in patients with high-grade degenerative arthropathy, in terms of clinical, functional and radiological outcomes and possible complications.

Methods

This retrospective study included 73 patients, aged between 47 and 79 years (mean age 61.7 ± 14.2 years), who underwent trans-fibular total ankle arthroplasty. All patients were followed up for at least two years post-operatively with mean follow-up 31.2 ± 8.1 months and have been evaluated clinically and radiographically both pre-operatively and post-operatively.

Results

Patients demonstrated a significant improvement in average AOFAS score, SF-36 score and VAS scale. Average plantarflexion improved from 9.9° ± 4.2 to 18.4° ± 6.3 and dorsiflexion from pre-operative mean value of 6.8° ± 5.8 to 17.2° ± 3.1 post-operative. Complications recorded in our series were 16 (21.9%), specifically 2 major complications and 14 minor complications.

Conclusions

This study found that trans-fibular total ankle replacement is a safe and effective option for patients with ankle osteoarthritis, resulting in improvement of patient-reported outcomes, range of motion, and radiographic parameters. However, further studies are required to determine long-term performance of these implants.

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Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Authors and Affiliations

  1. II Clinic of Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy

    Massimiliano Mosca, Silvio Caravelli, Emanuele Vocale, Nicolò Maitan, Alberto Grassi, Simone Massimi, Mario Fuiano & Stefano Zaffagnini

  2. Dipartimento Scienze Biomediche e Neuromotorie DIBINEM, Università di Bologna – Alma Mater Studiorum, Bologna, Italy

    Silvio Caravelli

Authors
  1. Massimiliano Mosca
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  2. Silvio Caravelli
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  3. Emanuele Vocale
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  4. Nicolò Maitan
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  5. Alberto Grassi
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  6. Simone Massimi
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  7. Mario Fuiano
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  8. Stefano Zaffagnini
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Corresponding author

Correspondence to Silvio Caravelli.

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Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethics

All patients were informed about the surgical procedure, post-operative treatment and possible complications and signed a written informed consent. The study was conducted according to the Declaration of Helsinky.

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Level of evidence: Level IV, Retrospective.

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Mosca, M., Caravelli, S., Vocale, E. et al. Clinical-radiological outcomes and complications after total ankle replacement through a lateral transfibular approach: a retrospective evaluation at a mid-term follow-up. International Orthopaedics (SICOT) 45, 437–443 (2021). https://doi.org/10.1007/s00264-020-04709-4

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  • DOI: https://doi.org/10.1007/s00264-020-04709-4

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