Introduction

Total ankle arthroplasty (TAA), tibiotalar (TT) arthrodesis and tibiotalocalcaneal (TTC) arthrodesis are common surgical procedures that are sometimes concurrent. The functional results of TTC are deemed to be inferior because of the double joint sacrifice. Patient-Reported Outcome Measures (PROMs), as well as satisfaction scores, are commonly used to assess the outcome of these surgeries, but lack at capturing patients’ ability to cope with potential functional limitations. The objective of our study was to compare the results of TAA, TT and TTC arthrodeses according to patients’ point of view. We proposed two hypotheses: 1) TAA confer better results than TT arthrodeses, 2) and TT arthrodeses confer better results than TTC arthrodeses, on this specific criterion.

Material and methods

We carried out a retrospective study integrating all TAA, TT and TTC arthrodeses performed in our center from 2010 to 2017. These surgeries were compared using PROMs (Foot Function Index (FFI), Foot and Ankle Outcome Scale (FAOS) and 12-Item Short Form Survey (SF-12)), a satisfaction rating and self-reported perceived recovery state.

Results

Fifty-one patients were included in the TAA group, 50 in the TT group and 51 in the TTC group. The mean duration of follow-up was 46 ± 20.8 months. The TAA group had better results than the TT group regarding the FFI score and satisfaction, thus confirming our primary hypothesis. On the other hand, no significant difference was found between the TT group and the TTC group, which invalidated our secondary hypothesis. No significant difference between the groups was found regarding the distribution of patients’ perceived recovery state.

Conclusion

Our hypothesis was not confirmed. In fact, TAAs, TT and TTC arthrodeses presented substantially similar results. Although it is difficult to compare surgeries with different indications, it is surprising to find that the patients’ perceived recovery state, deviating from the usual clinical and radiological results, are relatively similar.

Level of evidence

IV; Retrospective study.

中文翻译：

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患者对全踝关节置换术、胫距和胫距跟关节固定术长期结果的看法

介绍

全踝关节置换术 (TAA)、胫距 (TT) 关节固定术和胫距跟 (TTC) 关节固定术是常见的外科手术，有时会同时进行。由于双关节牺牲，TTC 的功能结果被认为较差。患者报告的结果测量 (PROM) 以及满意度评分通常用于评估这些手术的结果，但缺乏捕捉患者应对潜在功能限制的能力。我们研究的目的是根据患者的观点比较 TAA、TT 和 TTC 关节固定术的结果。我们提出了两个假设：1) TAA 提供比 TT 关节固定术更好的结果，2) 和 TT 关节固定术提供比 TTC 关节固定术更好的结果，在这个特定标准上。

材料与方法

我们进行了一项回顾性研究，整合了 2010 年至 2017 年在我们中心进行的所有 TAA、TT 和 TTC 关节固定术。使用 PROM（足部功能指数 (FFI)、足部和踝关节结果量表 (FAOS) 和 12 项短项目）对这些手术进行了比较表格调查 (SF-12)），满意度评分和自我报告的感知恢复状态。

结果

TAA 组 51 名患者，TT 组 50 名，TTC 组 51 名。平均随访时间为 46  ±  20.8 个月。TAA 组在 FFI 评分和满意度方面的结果优于 TT 组，从而证实了我们的主要假设。另一方面，TT 组和 TTC 组之间没有发现显着差异，这推翻了我们的第二个假设。在患者感知恢复状态的分布方面，两组之间没有显着差异。

结论

我们的假设没有得到证实。事实上，TAA、TT 和 TTC 关节固定术呈现出基本相似的结果。虽然很难比较不同适应症的手术，但令人惊讶的是，患者感知到的恢复状态与通常的临床和放射学结果不同，但相对相似。

证据等级

四；回顾性研究。