Total ankle arthroplasty聽-聽Total ankle arthroplasty in Western France: Influence of volume on complications and clinical outcome

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• 作者：N. Pinar^a ; E. Vernet^b ; P. Bizot^a ; J. Brilhault^c ; ^{jean.brilhault@med.univ-tours.fr}
• 关键词：Arthroplasty ; Ankle ; Osteoarthritis
• 刊名：Orthopaedics Traumatology ; Surgery Research
• 出版年：2012
• 期刊代码：P108_18770568
• 类别：med
• 出版时间：June, 2012
• 卷：98
• 期：4_supp_S
• 页码：S26-S30
• 文件大小：349 K

摘要

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Summary

Introduction

Total ankle arthroplasty (TAA) has become an alternative to ankle arthrodesis in the treatment of advanced osteoarthritis. 鈥淭he difficulty of performing a total ankle replacement and the corresponding steep learning curve鈥?has resulted in a proposal 鈥渢o limit ankle replacement to centers that have performed at least ten total ankle replacements for at least 3 years鈥? The aim of this study was to evaluate the influence of the frequency of TAA procedures on the complications and outcome of these arthroplasties.

Materials and methods

This retrospective series included 183聽cases who underwent surgery between 1997-2010 in eight centers: three high volume centers performed at least five TAA per year (100聽cases) and six low volume centers performed less than five TAA per year (78聽cases).

Results

The clinical assessment was performed in 133 cases that were reviewed after a mean 39 months 卤 29 of follow-up. The preoperative AOFAS score was 33 卤 4 and 77 卤 15 at the final follow-up. The five-year survival rate was 86%. No significant difference was found between the groups for the AOFAS score or implant survival at the final follow-up. The high volume centers experienced more complications (45%versus 13%) but fewer implant failures (8%versus 13%) overall compared to the low volume centers.

Discussion

The outcome of TAA depends mainly upon the pertinence of the indication and the associated procedures that may be necessary. Rather than limiting TAA to high volume reference centers, we suggest that the assessment of each case within a predetermined area should be done in a network. This would determine the degree of specialization required for each TAA case and provide all patients with safe and equal access to this therapeutic option.

Level of evidence

IV聽-聽Retrospective study.