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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EEnd-stage ankle arthritis is a disabling condition, with similar morbidity, pain, and loss of function as hip arthritis. Open ankle arthrodesis (OAA) has been the gold standard for treatment of end-stage ankle arthritis, but better outcomes have been obtained with arthroscopic ankle arthrodesis (AAA). The aim of the study discussed in this article, was to compare the outcomes of total ankle replacement, AAA, and OAA in patients with isolated, nondeformed ankle arthritis.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArthritis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EFoot \u0026amp; Ankle Conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EArthritis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EFoot \u0026amp; Ankle Conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EEnd-stage ankle arthritis is a disabling condition, with similar morbidity, pain, and loss of function as hip arthritis. Open ankle arthrodesis (OAA) has been the gold standard for treatment of end-stage ankle arthritis, but better outcomes have been obtained with arthroscopic ankle arthrodesis (AAA). Total ankle replacement (TAR) and fusion outcomes depend on the involvement of the surrounding joints and the presence of intra-articular or extra-articular deformity. Historically, the results and longevity of TAR have been less reproducible. Ankle replacement is gaining in popularity with the availability of newer designs.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe aim of this study, presented by Andrea Nicole Veljkovic, MD, University of Toronto, Toronto, Ontario, Canada, was to compare the outcomes of TAR, AAA, and OAA in patients with isolated, nondeformed ankle arthritis. This prospective study enrolled 104 women and 134 men aged \u0026gt; 17 years with Canadian Orthopedic Foot and Ankle Society type 1, isolated, nondeformed arthritic ankles, with \u0026lt; 10\u00b0 of intra-articular and extra-articular deformity and no arthritis in the triple-joint complex.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe patients underwent TAR (n = 88), AAA (n = 50), or OAA (n = 100). The primary outcome measure was substantial reoperation and Ankle Osteoarthritis Scale (AOS) total change score. The secondary outcome measures were physical and mental component summary change scores. End points included survivorship with removal of the metal components for TAR, revision of the arthrodesis, and substantial reoperation. The patients were followed for an average of 3.57 \u00b1 1.60 years.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary outcome results showed that there were more reoperations in and about the ankle for TAR. There was a trend toward substantial revision rates in patients who underwent TAR and OAA. Patients with TAR had more substantial reoperation rates than did those with AAA or OAA (\u003Cem\u003EP\u003C\/em\u003E = .0003).\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EAn analysis of the effects of surgery type on substantial reoperation rates\u2014controlling for age, body mass index, and sex\u2014found that patients with TAR had more reoperations (Pr \u0026gt; ChiSq = .0112). There were significant differences among the groups in the AOS change score (\u003Cem\u003EP\u003C\/em\u003E = .0050), AOS pain difference (\u003Cem\u003EP\u003C\/em\u003E = .0486), and AOS difficulty difference (\u003Cem\u003EP\u003C\/em\u003E = .0013), with the TAR and AAA groups faring better than the OAA group.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThere were no significant differences between TAR and AAA in AOS total difference, AOS pain difference, AOS difficulty difference, physical component summary difference, or mental component summary difference. The TAR group had more substantial reoperations versus the AAA group (\u003Cem\u003EP\u003C\/em\u003E = .0019). There were significant differences with AAA versus OAA in mean AOS total difference (38.31 vs 25.82; \u003Cem\u003EP\u003C\/em\u003E = .0043), AOS pain difference (36.12 vs 25.64; \u003Cem\u003EP\u003C\/em\u003E = .0278), and AOS difficulty difference (40.50 vs 25.99; \u003Cem\u003EP\u003C\/em\u003E = .0017) but not in substantial reoperation (4.0% vs 7.0%; \u003Cem\u003EP\u003C\/em\u003E = .7183). Significant differences were observed between TAR and OAA in mean AOS total difference (34.41 vs 25.82; \u003Cem\u003EP\u003C\/em\u003E = .0163), AOS difficulty difference (36.66 vs 25.99; \u003Cem\u003EP\u003C\/em\u003E = .0045), and substantial reoperation (23.86% vs 7.00%; \u003Cem\u003EP\u003C\/em\u003E = .0017).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EBased on the AOS total, pain, and difficulty change scores, TAR and AAA had significantly better outcomes than OAA. There were significantly fewer revisions and substantial reoperations with AAA and OAA than with TAR. TAR and AAA are relatively comparable options for the treatment of end-stage type 1 ankle arthritis with regard to outcomes.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/34\/19.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzorcp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}