Introduction

The severity of a foot or ankle deformity is a major prognostic factor for the success of ankle replacement. Varus deformity is at once the most arthrogenic and the most frequent.

Hypothesis

The severity of preoperative varus is a negative factor for ankle replacement survival.

Material and method

A retrospective study compared results in a continuous series of 57 Salto-Talaris® ankle replacements according to preoperative varus: 31 moderate (5–15̊) and 26 severe (> 15̊). Radiological and clinical assessment at a minimum 1 year focused on complications, revision and implant exchange and on AOFAS score, range of motion and tibiotalar angle at last follow-up.

Results

At a mean 2.4 years’ follow-up, implant survival in the moderate and severe varus groups was respectively 83% and 92%. Postoperative AOFA score and range of motion improved significantly in both groups, without significant difference. Analysis of cumulative survival showed no significant intergroup difference.

Discussion

Severity of preoperative varus did not impact implant survival. Only postoperative alignment and stability emerged as survival factors. These results were related to the quality of associated procedures aiming to reduce deformity and to achieve ligament balance.

Level of evidence

IV, retrospective comparative study.

中文翻译：

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术前内翻对踝关节置换生存率的影响

介绍

足部或踝关节畸形的严重程度是踝关节置换术成功与否的主要预后因素。内翻畸形是最常见的关节源性畸形。

假设

术前内翻的严重程度是踝关节置换存活的不利因素。

材料与方法

一项回顾性研究根据术前内翻比较了连续 57 例 Salto-Talaris® 踝关节置换术的结果：31 例中度 (5–15̊) 和 26 例重度 (> 15̊)。至少 1 年的放射学和临床评估侧重于并发症、翻修和植入物更换以及最后一次随访时的 AOFAS 评分、运动范围和胫距角度。

结果

在平均 2.4 年的随访中，中度和重度内翻组的种植体存活率分别为 83% 和 92%。两组术后AOFA评分和活动范围均有明显改善，无显着差异。累积生存分析显示无显着组间差异。

讨论

术前内翻的严重程度不会影响植入物的存活率。只有术后排列和稳定性成为生存因素。这些结果与旨在减少畸形和实现韧带平衡的相关程序的质量有关。

证据等级

四、回顾性比较研究。