Abstract
Aim
Young patients with ankle arthritis that remains symptomatic in spite of conservative treatment and following arthroscopic debridement are usually offered either ankle fusion or ankle replacement. Both these options are far from ideal in this age group. The aim of this study was to evaluate functional outcomes following ankle distraction to determine whether it is a reliable alternative for the treatment of ankle arthritis in young adults.
Material and methods
Data was collected prospectively for 15 patients (9 males and 6 females, mean age 31.9 years) with “stage 2” ankle arthritis who failed conservative treatment and continued to be symptomatic following arthroscopic ankle debridement. Distraction of 8 mm was done using a dynamic constrained ankle circular frame and all patients were allowed full weight bearing all through the distraction process. The subjective functional evaluation was based on the American Orthopaedic Foot and Ankle Score (AOFAS), the Foot Disability Index (FADI) and the Visual Analogue Score (VAS). In 10 patients the Manchester Oxford Foot questionnaire (MOXFQ) and the Short Form (SF) 12 patient satisfaction questionnaire were also filled preoperatively and at final follow up.
Results
At a minimum follow-up of 24 months (mean 34.4) none of the patients required fusion or replacement. There was a significant improvement in all the functional outcome scores. There was also a significant improvement in the ankle joint space on weight bearing x-rays.
Conclusion
Based on these results the use of ankle distraction can be considered a useful option for the treatment of symptomatic “stage 2” ankle arthritis in young adults. Longer-term follow-up and comparison with alternative techniques will be required to evaluate the true effectiveness of this treatment option.
