Abstract
Introduction and aim: In a prospective comparative study we were interested in the question, wether the total ankle arthroplasty in the midterm FU, especially in patients with RA, is a successful and correctly indicated surgical procedure. We compared our clinical and radiological results with a cohort of patients with OA. Furthermore we analysed especially the rheuma patients for their known periarticular osteopenia and the cementless fixation as a possible contraindication for the ankle arthroplasty.
Material and methods: With a mean FU of 4,4 years and a total number of 153 total ankle arthroplasties from 07/1997 to 12/2003 we assessed 92 patients with 94 S.T.A.R total ankle arthroplasties. Indication for this surgical procedure was the rheumatoid arthritis in 26 patients (27.7%) and an idiopathic osteoarthritis of the upper ankle joint in 29 cases (30.8%), furthermore a posttraumatic osteoarthritis in 39 patients (41.5%)
Results: The functional increase in their range of motion (ROM) and the significant decrease of pain are the most important and impressing facts for the patients.
The increase of ROM in all patients is 17.9 (RA: 18.7 /OA: 16.6). Significant pain relief is described by 92.4% of patients, here all the groups showed no significant differences. An increase in the clinical outcome measured by the Kofoeds Ankle Score is seen from < 70 pts. preoperatively (100% of patients) to > 75 pts. postoperatively (82.3% of patients). The most frequent complication especially in patients with RA is a delayed wound healing (19%), but the revision rate is higher in patients with traumatic and idiopathic osteoarthritis (17% OA /13% RA). A secondary arthrodesis has to be performed only in 2 OA cases.
Conclusion: Rheumatoid arthritis in the LDE stage IV and V is the adequate indication for the S.T.A.R. prosthesis. The functional benefit and the clinical outcome is satisfying, the results for the rheumatoid arthritis patients are comparable to other indications. Periarticular osteopenia is not considered as a contraindication.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
