Total ankle replacement in 35 cases / 中国组织工程研究

ABSTRACT

Thirty-five patients who underwent Scandinavian total ankle replacement (STAR) in the Union Hospital, Huazhong University of Science and Technology & First Affiliated Hospital of Nanchang University between March 1999 and November 2006 were recruited for this study. The patients averaged 50.5 years old ranging from 27 to 68 years old. STAR was performed on the left side in 20 cases and on the right side in 15 cases. Among these patients, 12 suffered from posttraumatic arthritis, 8 osteoarthritis, and 15 rheumatic arthritis. All patients complained of ankle joint pain and different degrees of swelling as well as limited motion of joint. During the operation, some complications appeared, including medial malleolus fractures 2 patients, unstable ankle joint introversion 2 patients, limited ankle joint dorsiflextion 1 pateint. Symptomatic treatments were performed in these patients. Postoperatively, injury of superficial peroneal nerve occurred in 1 patient, but this did not cause an obvious motor dysfunction, so no special treatment was given. In addition, infection of incisional wound appeared in 2 patients and late healed subsequent to another dressing. Thirty-three cases presented with primary healing of incision. Among 35 total ankle arthroplasties, 28 had detained 43.5-month follow up (range 3-80 months). The ankles were scored with Kofoed total scoring system. The average postoperative ankle score was 85.5 (range 58-95), pain degree score was 48.3 (range 35-50), joint function score was 20.7 (range 18-30), and range-of-motion score was 17.2 (range 16-20). There was significant difference in these scores as compared to preoperative scores (P < 0.01). None of prosthetic loosening and migration was found radiologically. All these indicated that standardized and normalized operative technique as well as operative tools closely matched to the prosthesis and used to prevent and treat postoperative infection, dislocation, and prosthetic loosening as well as histocompatibility between material and host are the essential conditions for enhancing the success rate of prosthetic replacement.