Dataset Information

Total Ankle Arthroplasty for Rheumatoid Arthritis in Japanese Patients: A Retrospective Study of Intermediate to Long-Term Follow-up.

ABSTRACT:

Background

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.

Methods

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.

Results

This procedure significantly improved the clinical scores of the JSSF rheumatoid arthritis foot and ankle scale (p < 0.0001). 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 (p < 0.01) at the time of the latest follow-up were all significantly lower in the biologic treatment group.

Conclusions

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.

Level of evidence

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

SUBMITTER: Hirao M

PROVIDER: S-EPMC6133145 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Publications

Total Ankle Arthroplasty for Rheumatoid Arthritis in Japanese Patients: A Retrospective Study of Intermediate to Long-Term Follow-up.

Hirao Makoto M Hashimoto Jun J Tsuboi Hideki H Ebina Kosuke K Nampei Akihide A Noguchi Takaaki T Tsuji Shigeyoshi S Nishimoto Norihiro N Yoshikawa Hideki H

JB & JS open access 20171128 4

<h4>Background</h4>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.<h4>Methods</h4>We performed a retrospective observational study involving 50 ankles (44 patients) that underwent TAA for ...[more]

PMID: 30229229

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Project description:BackgroundJoint replacement procedures have traditionally been performed in an inpatient setting to minimize complication rates. There is growing evidence that total ankle arthroplasty (TAA) can safely be performed as an outpatient procedure, with the potential benefits of decreased health care expenses and improved patient satisfaction. Prior studies have not reliably made a distinction between outpatient TAA defined as length of stay <1 day and same-day discharge. The purpose of our study was to compare a large volume of same-day discharge and inpatient TAA for safety and efficacy.MethodsPatients undergoing TAA at our US-based institution are part of an institutional review board-approved registry. We queried the registry for TAA performed by the single highest-volume surgeon at our institution between May 2020 and March 2022. Same-day discharge TAA was defined as discharge on the day of the procedure. Patient demographics, baseline clinical variables, concomitant procedures, postoperative complications, and patient-reported outcomes were collected. Postoperative outcomes were compared after 1:1 nearest-neighbor matching by age, sex, Charlson Comorbidity Index (CCI), and American Society of Anesthesiologists (ASA) score. Multivariable models were created for comparison with the matched cohort outcome comparison analysis.ResultsOur same-day discharge group was younger (median 58 vs 67 years; P < .001), with proportionally fewer females (36.4% vs 51.4%; P = .044) and lower Charlson Comorbidity Indices (median 1 vs 3; P < .001) than the inpatient group. At a median follow-up of 1 year, after matching by age, sex, CCI, and ASA score, there was no difference in complications (P = .788), reoperations (P = .999), revisions (P = .118), or Patient-Reported Outcomes Measurement Information System (PROMIS) scores between the 2 groups. Multivariable analyses performed demonstrated no evidence of association between undergoing same-day discharge TAA vs inpatient TAA and reoperation, revision, complication, or 1-year PROMIS scores (P > .05).ConclusionIn our system of health care, with appropriate patient selection, same-day discharge following TAA can be a safe alternative to inpatient TAA.Level of evidenceLevel III, retrospective cohort study.

Dataset Information

Total Ankle Arthroplasty for Rheumatoid Arthritis in Japanese Patients: A Retrospective Study of Intermediate to Long-Term Follow-up.

Background

Methods

Results

Conclusions

Level of evidence

Publications

Total Ankle Arthroplasty for Rheumatoid Arthritis in Japanese Patients: A Retrospective Study of Intermediate to Long-Term Follow-up.

Similar Datasets

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