PURPOSE To evaluate and compare complication rates and postoperative outcomes in patients with ankle debridement alone vs. debridement and hinged ankle distraction arthroplasty. METHODS A total of 50 patients with posttraumatic ankle osteoarthritis (OA) with a mean age of 40.0 ± 8.5 years were included into this prospective randomized study: 25 patients in ankle debridement alone group and 25 patients in debridement and hinged ankle distraction group. The mean follow-up was 46 ± 12 months (range 36-78 months). The clinical and radiographic outcomes were evaluated at the 6-month and 3-year follow-up using the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, SF-36 quality of life score, and van Dijk OA classification. A Kaplan-Meier survival analysis was performed to calculate the 3-year and 5-year survival rates. RESULTS Both patient groups experienced significant pain relief, functional improvement, and improvement in quality of life postoperatively. In total, 26 major secondary procedures were performed. The overall survival rates in the debridement and ankle distraction group were 19 of 25 (74%) and 15 of 25 (59%) at 3 years and 5 years, respectively. The overall survival rates in the ankle debridement alone group were 12 of 25 (49%) and 9 of 25 (34%) at 3 years and 5 years, respectively. CONCLUSIONS The study demonstrated comparable postoperative functional outcome and quality of life. However, rate of postoperative revision surgery was substantially higher in ankle debridement alone group. LEVEL OF EVIDENCE Randomized controlled study, Level I.

中文翻译：

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在踝关节骨关节炎患者中，清创术和铰链运动分心术优于单纯清创术：一项前瞻性随机对照试验。

目的评估和比较单纯清创术与清创术和铰接式踝关节置换术患者的并发症发生率和术后结局。方法这项前瞻性随机研究共纳入50例平均年龄为40.0±8.5岁的创伤后踝关节骨关节炎（OA）患者：25例单独进行踝关节清创术的患者和25例清创和踝关节牵张术的患者。平均随访时间为46±12个月（范围36-78个月）。在6个月和3年的随访中，使用视觉模拟量表（VAS），美国矫形足踝学会（AOFAS）后足评分，SF-36生活质量评分和货车评估了临床和放射学结果Dijk OA分类。进行Kaplan-Meier生存分析以计算3年和5年生存率。结果两组患者术后均有明显的疼痛缓解，功能改善和生活质量改善。总共进行了26次主要的次要手术。清创术和踝关节分散术组在3年和5年时的总生存率分别为25分之19（74％）和25分之15（59％）。仅踝关节清创术组在3年和5年时的总生存率分别为25分之12（49％）和25分之9（34％）。结论该研究证明了可比的术后功能结局和生活质量。但是，仅踝关节清创组的术后翻修手术率显着较高。证据水平随机对照研究，I级。