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Debridement and hinged motion distraction is superior to debridement alone in patients with ankle osteoarthritis: a prospective randomized controlled trial

  • ANKLE
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

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.

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Acknowledgements

We thank Maxwell Weinberg, BS (Department of Orthopaedics, University of Utah, Salt Lake City, UT) for his help with manuscript correction and editing review.

Funding

None.

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Authors and Affiliations

  1. Orthopaedic Department, University Hospital of Canary Islands, Carretera La Cuesta s/n, 38320, San Cristóbal de La Laguna, Tenerife, Spain

    Mario Herrera-Perez

  2. Orthopaedic Department, College of Medicine, Taibah University, Medina, Kingdom of Saudi Arabia

    Yousef Alrashidi

  3. Nasser Institute for Research and Treatment, Cairo, Egypt

    Ahmed E. Galhoum

  4. Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT, 84108, USA

    Timothy L. Kahn & Alexej Barg

  5. Orthopaedic Department, Schmerzklinik Basel, Basel, Switzerland

    Victor Valderrabano

Authors
  1. Mario Herrera-Perez
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  2. Yousef Alrashidi
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  3. Ahmed E. Galhoum
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  4. Timothy L. Kahn
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  5. Victor Valderrabano
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  6. Alexej Barg
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Corresponding authors

Correspondence to Mario Herrera-Perez or Alexej Barg.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was conducted in accordance with the Declaration of Helsinki and the Guidelines for Good Clinical Practice. The study protocol was approved by the institutional review board (University Hospital of Canary Islands) and informed consent was obtained from all study participants prior to their enrollment.

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Herrera-Perez, M., Alrashidi, Y., Galhoum, A.E. et al. Debridement and hinged motion distraction is superior to debridement alone in patients with ankle osteoarthritis: a prospective randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 27, 2802–2812 (2019). https://doi.org/10.1007/s00167-018-5156-3

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  • DOI: https://doi.org/10.1007/s00167-018-5156-3

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