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Total Ankle Arthroplasty for Rheumatoid Arthritis in Japanese Patients
- Source :
- JBJS Open Access. 2:e0033
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Outcomes after total ankle arthroplasty (TAA) combined with additive techniques (augmentation of bone strength, control of soft-tissue balance, adjustment of the loading axis) for the treatment of rheumatoid arthritis were evaluated after intermediate to long-term follow-up. The influences of biologic treatment on the outcomes after TAA were also evaluated.We performed a retrospective observational study involving 50 ankles (44 patients) that underwent TAA for the treatment of rheumatoid arthritis. The mean duration of follow-up was 7.1 years. Clinical outcomes were evaluated with use of the Japanese Society for Surgery of the Foot (JSSF) scale score and a postoperative self-administered foot-evaluation questionnaire (SAFE-Q). Radiographic findings were evaluated as well. These parameters also were compared between patients managed with and without biologic treatment.This procedure significantly improved the clinical scores of the JSSF rheumatoid arthritis foot and ankle scale (p0.0001). Forty-eight of the 50 ankles had no revision TAA surgery. Subsidence of the talar component was seen in 8 ankles (6 in the biologic treatment group and 2 in the non-biologic treatment group); 2 of these ankles (both in the biologic treatment group) underwent revision TAA. The social functioning score of the SAFE-Q scale at the time of the latest follow-up was significantly higher in the biologic treatment group (p = 0.0079). The dosage of prednisolone (p = 0.0003), rate of usage of prednisolone (p = 0.0001), and disease-activity score (p0.01) at the time of the latest follow-up were all significantly lower in the biologic treatment group.TAA is recommended for the treatment of rheumatoid arthritis if disease control, augmentation of bone strength, control of soft-tissue balance, and adjustment of the loading axis are taken into account. The prevention of talar component subsidence remains a challenge in patients with the combination of subtalar fusion, rheumatoid arthritis, and higher social activity levels.Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
business.industry
Long term follow up
MEDLINE
030209 endocrinology & metabolism
Retrospective cohort study
medicine.disease
03 medical and health sciences
0302 clinical medicine
Bone strength
Rheumatoid arthritis
Total ankle arthroplasty
Physical therapy
Medicine
Orthopedics and Sports Medicine
Surgery
030101 anatomy & morphology
business
Balance (ability)
Subjects
Details
- ISSN :
- 24727245
- Volume :
- 2
- Database :
- OpenAIRE
- Journal :
- JBJS Open Access
- Accession number :
- edsair.doi.dedup.....bf51ace88f76103188c60d43ad68ffa3
- Full Text :
- https://doi.org/10.2106/jbjs.oa.17.00033