Transfibular Total Ankle Arthroplasty: Clinical, Functional, and Radiographic Outcomes and Complications at a Minimum of Five Years Follow-up
Notice bibliographique
Résumé
Category: Ankle Arthritis; Ankle Introduction/Purpose: Total ankle arthroplasty (TAA) has surpassed arthrodesis as the gold standard for treatment of end-stage ankle arthritis. The Zimmer Trabecular Metal Total Ankle Implant (Zimmer-Biomet, Warsaw, IN) differs from other newer- generation implants in the transfibular approach, non-mobile-bearing prosthesis, high-molecular-weight polyethylene, curved surface at every interface in the sagittal plane, and shallow resection depth. There is limited mid-term follow-up for this system. Therefore, we sought to report mid-term clinical, functional, and radiographic results we well as complications and survival for patients treated with the transfibular TAA at a minimum of 5-years follow-up. Methods: A retrospective review was performed on patients who underwent primary transfibular TAA by a single surgeon from October 2012 to January 2018. Inclusion criteria was a minimum of 5-years of follow-up with a completed consent for participation in the study and patient-reported outcome measures (PROM). Patient demographics and perioperative data were collected. PROMS included: 12-item Short Form Health Survey (SF-12) physical (PCS) and mental (MCS) component scores; Ankle Osteoarthritis Scale (OAS); and Visual Analog Scale (VAS). Functional outcomes included range of motion (ROM) measured on weightbearing ROM radiographs. Radiographic outcomes included coronal and sagittal alignment. Adverse events and reoperations were reported using the Canadian Orthopedic Foot and Ankle Society (COFAS) Reoperation Coding System (CROCS). Of the consecutive 151 TAAs, 83 (55.0%) ankles are included in this study, evaluated at a mean of 5.8 years clinical and 6.3 years radiographic follow-up. Results: The average age was 60.6 years-old. Preoperative tibiotalar coronal deformity included 27 valgus (10°, range 2-20°) and 25 varus ankles (-9°, range -2--25°), successfully corrected to neutral postoperatively. The postoperative PROMs were: SF-12 PCS: 40.4, SF-12 MCS: 56.0, VAS: 2.3, AOS Pain: 17.0, and AOS Disability: 24.9. Radiographic postoperative tibiopedal ROM was 17.8° dorsiflexion and 21.8° degrees plantarflexion. The overall reoperation rate was 38.6%(n=32) at an average of 28.7 months postoperative. Most common were removal of the fibula hardware (n=21,25.3%) and medial gutter debridement (n=15, 18.1%). There were 3 (3.6%) cases of acute postoperative infection (< 3 months) treated with operative irrigation and debridement but retention of the metal components. There were no cases of septic or aseptic loosening or subsidence. The overall implant survival, defined by retention of the metal components, was 100%. Conclusion: Transfibular TAA is a safe and effective treatment for end-stage ankle arthritis at 5-year mid-term follow-up. This study confirms excellent clinical results including PROMs and ROM as well as radiographic alignment correction and maintenance. The survival rate was 100% for retention of the trabecular metal components. The survival rate to reoperation was 60.7% with patients commonly requiring removal of the fibula hardware or medial gutter debridement. Patients should be counseled on the risk of reoperation preoperatively for postoperative expectation management.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».