Foot & Ankle International - 2017 FAI Supplement - 21S
the treatment of chronic Achilles tendinopathy (March 2012 March 2015). Charts were reviewed for clinical data, associated
treatments and complications. Preoperative assessment
included the Visual Analogue Score (VAS), SF-36 health status
survey and the lower extremity functional scale (LEFS). At
final follow up we evaluated pain level, range of motion of the
ankle and the toes, ability to perform single leg raise and toe
walking, calf atrophy and complications. Postoperative outcomes were assessed by Visual Analogue Score (VAS), SF-36
health survey, Lower Extremity Functional Scale (LEFS), Foot
Function Index (FFI), VISA-A score and the Foot and Ankle
Ability Measure (FAAM). Fifteen patients (seventeen feet), 6
males and 9 females, mean age of 53.6 years (27-76 years) and
an average body mass index of 31.4 kg/m2 (20.5 to 45.4 kg/m2)
were included in the study.
Results: Mean follow-up was 27.5 months (15-49). Four
patients (6 feet) had prior surgeries, including two patients
with failed FHL transfer. We found significant clinical
improvement when comparing pre-operative and postoperative VAS scores (6.0±3.3 versus 1±1.36; p<0.001), SF-36
physical component summary (28.2±10.7 versus 45.0±11.1;
p<0.002) and LEFS (36.4±22 versus 57.9±20.5; p<0.011). At
final follow up, 6/7 patients (86%) returned to prior levels of
recreational sport activities. No differences were found on
single leg raise test when compared to uninvolved side. One
patient reported weakness for plantar flexion of the toes, without gait complaints. Mean VISA-A was 52.6 points (15-85),
Foot Function Index (FFI) 21.2% (0-65%) and FAAM 86.2%
(55.3-100%) for the FAAM. Three patients had superficial
infection and two patients had deep infection, requiring surgical debridement.
Conclusion: FDL tendon transfer represents a safe surgical
alternative as a method of augmentation during the treatment
of chronic Achilles tendinopathy. Our study showed comparable clinical and functional outcomes to FHL tendon transfer
and minimal complications or donor site morbidity.
Foot & Ankle International, 38(S1)
DOI: 10.1177/1071100717S00018
©The Author(s) 2017
Mid- to Long-Term Results of Total
Ankle Replacement in Patients With
Hemophilic Arthropathy
Franziska Eckers, MD, Andreas Hingsammer,
MMed(Orth), Reto Sutter, MD,
AOFAS Annual Meeting 2017
Stephan Wirth, MD, Brigitte Brand-Staufer, MD,
Arnd Viehöfer, MD
Category: Ankle Arthritis
Keywords: hemophilia; hemophilic arthropathy; ankle; total
ankle replacement; arthroplasty; outcome
Introduction/Purpose: Hemophilia is a rare hematological
disease associated with spontaneous joint hemorrhaging
causing hemophilic arthropathy. Symptoms comprise joint
pain and deformity, paired with loss of function. In the presence of advanced joint deterioration, therapeutic options are
confined to either arthroplasty or arthrodesis. For the ankle,
the latter is still referred to as the procedure of choice.
However - in light of its capacity to reduce pain while preserving ankle motion - total ankle replacement (TAR) has
recently gained acceptance as an alternative. The aim of this
study was to investigate the mid- to long-term results of
TAR in hemophilic ankle arthropathy.
Methods: Seventeen TARs were implanted between 1998
and 2012 (mean age: 43 years). Preoperative demographic
and disease specific data, complications and revision surgeries were recorded. With a mean follow-up of 9.3 years
(range, 2.2-17.8) implant survival was estimated using
Kaplan-Meier analysis. Follow-up assessment of 12 TARs
was performed after 9.6 years (5 lost to follow-up).
Satisfaction and pain scales, the AOFAS hindfoot-score,
and the SF-36 were obtained to assess clinical outcome.
Radiographic evaluation of pre- and follow-up radiographs
was conducted.
Results: Three cases (17.6%) had undergone TAR removal
secondary to loosening at an average interval of 7.5 years.
The estimated implant survival was 94% at 5, 85% at 10, and
70% at 15 years (95% CI, 11.9-17.7). The mean estimated
implant survival was 14.77 years (95% CI, 11.9-17.7). The
mean level of satisfaction was 76%, and of pain 2/10 (VAS).
ROM had increased significantly (p=0.037). The SF-36 summary scores were comparable to those of a matched standard
population. The AOFAS hindfoot-score averaged 81/100
points.
Conclusion: TAR is a viable treatment option for
advanced hemophilic ankle arthropathy. Based on the
herein presented follow-up, implant survival compares to
that of non-hemophilic populations. Clinical mid- to
long-term results are favorable. However, the majority of
follow-up radiographs revealed component loosening
and/or periprosthetic lucency. Considering the study population's young age and specific risk factors, need for
revision surgery secondary to symptomatic component
loosening may arise.
21S
Table of Contents for the Digital Edition of Foot & Ankle International - 2017 FAI Supplement
TOC 1
TOC 2
TOC 3
TOC Page 4 + Verso
Editorial Board
President's Introduction
AOFAS Annual Meeting Abstracts 2017
AOFAS Annual Meeting Abstracts 2017
Foot & Ankle International - 2017 FAI Supplement - CT1
Foot & Ankle International - 2017 FAI Supplement - CT2
Foot & Ankle International - 2017 FAI Supplement - Cover1
Foot & Ankle International - 2017 FAI Supplement - Cover2
Foot & Ankle International - 2017 FAI Supplement - i
Foot & Ankle International - 2017 FAI Supplement - TOC 1
Foot & Ankle International - 2017 FAI Supplement - iii
Foot & Ankle International - 2017 FAI Supplement - TOC 2
Foot & Ankle International - 2017 FAI Supplement - 1A
Foot & Ankle International - 2017 FAI Supplement - 1B
Foot & Ankle International - 2017 FAI Supplement - v
Foot & Ankle International - 2017 FAI Supplement - TOC 3
Foot & Ankle International - 2017 FAI Supplement - vii
Foot & Ankle International - 2017 FAI Supplement - TOC Page 4 + Verso
Foot & Ankle International - 2017 FAI Supplement - Editorial Board
Foot & Ankle International - 2017 FAI Supplement - x
Foot & Ankle International - 2017 FAI Supplement - President's Introduction
Foot & Ankle International - 2017 FAI Supplement - AOFAS Annual Meeting Abstracts 2017
Foot & Ankle International - 2017 FAI Supplement - 3S
Foot & Ankle International - 2017 FAI Supplement - 4S
Foot & Ankle International - 2017 FAI Supplement - 5S
Foot & Ankle International - 2017 FAI Supplement - 6S
Foot & Ankle International - 2017 FAI Supplement - 7S
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Foot & Ankle International - 2017 FAI Supplement - 45S
Foot & Ankle International - 2017 FAI Supplement - 46S
Foot & Ankle International - 2017 FAI Supplement - AOFAS Annual Meeting Abstracts 2017
Foot & Ankle International - 2017 FAI Supplement - 48S
Foot & Ankle International - 2017 FAI Supplement - 49S
Foot & Ankle International - 2017 FAI Supplement - 50S
Foot & Ankle International - 2017 FAI Supplement - 51S
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Foot & Ankle International - 2017 FAI Supplement - Cover3
Foot & Ankle International - 2017 FAI Supplement - Cover4
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