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Arthrodese vs. Prothese bei endgradiger Arthrose am oberen Sprunggelenk

Ein Streitgespräch

Arthrodesis vs. prosthesis for end-stage osteoarthritis of the ankle joint

A scientific argument

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Zusammenfassung

Der Goldstandard in der operativen Behandlung der endgradigen Arthrose des oberen Sprunggelenks bleibt bis heute kontrovers. Letztlich konkurrieren die endoprothetische Versorgung, die in den letzten Jahren ganz wesentliche Verbesserungen erfahren hat, und die Arthrodese, die ausgezeichnete Ergebnisse, insbesondere auch in der arthroskopischen Technik, erzielen kann. Beide Techniken bieten spezifische Vor- und Nachteile, sodass die Indikationsstellung immer individuell unter Berücksichtigung der Bedürfnisse und individuellen Befundkonstellation der Patienten stattfinden sollte.

Abstract

The gold standard in operative treatment of end-stage ankle osteoarthritis remains controversial even now. Endoprosthetic treatment, which has undergone significant improvements in recent years competes with arthrodesis, which can achieve excellent results particularly in the arthroscopically assisted technique. Both procedures offer specific advantages and disadvantages so that the decision about indications for treatment should always be made individually, taking specific needs and the individual constellation of findings of the patient into consideration.

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Literatur

  1. Bhattacharjee S et al (2021) Do we need to wait 3 months after corticosteroid injections to reduce the risk of infection after total knee arthroplasty? J Am Acad Orthop Surg 29:e714–e721

    Article  Google Scholar 

  2. Brodsky JW et al (2016) Abnormalities of gait caused by ankle arthritis are improved by ankle arthrodesis. Bone Joint J 98:1369–1375

    Article  Google Scholar 

  3. Chao YS, Loshak H (2019) Intra-articular hyaluronic acid for osteoarthritis of the hip or ankle: a review of clinical effectiveness. CADTH rapid response reports. Canadian Agency for Drugs and Technologies in Health, Ottawa

    Google Scholar 

  4. Coester LM et al (2001) Long-term results following ankle arthrodesis for post-traumatic arthritis. J Bone Joint Surg Am 83:219–228

    Article  CAS  Google Scholar 

  5. Coetzee JC (2008) Management of varus or valgus ankle deformity with ankle replacement. Foot Ankle Clin 13:509–520

    Article  Google Scholar 

  6. Daniels TR et al (2014) Intermediate-term results of total ankle replacement and ankle arthrodesis: a COFAS multicenter study. J Bone Joint Surg Am 96:135–142

    Article  Google Scholar 

  7. Gentile MA (2017) Nonsurgical treatment of ankle arthritis. Clin Podiatr Med Surg 34:415–423

    Article  Google Scholar 

  8. Hobson SA et al (2009) Total ankle replacement in patients with significant pre-operative deformity of the hindfoot. J Bone Joint Surg Br 91:481–486

    Article  CAS  Google Scholar 

  9. Huang YC et al (2006) Effects of ankle-foot orthoses on ankle and foot kinematics in patients with subtalar osteoarthritis. Arch Phys Med Rehabil 87:1131–1136

    Article  Google Scholar 

  10. Jones CR et al (2018) Arthroscopic ankle arthrodesis: a 2–15 year follow-up study. Arthroscopy 34:1641–1649

    Article  Google Scholar 

  11. Kamrad I et al (2016) Outcome after salvage arthrodesis for failed total ankle replacement. Foot Ankle Int 37:255–261

    Article  Google Scholar 

  12. Kim BS et al (2009) Total ankle replacement in moderate to severe varus deformity of the ankle. J Bone Joint Surg Br 91:1183–1190

    Article  CAS  Google Scholar 

  13. Knupp M et al (2011) Classification and treatment of supramalleolar deformities. Foot Ankle Int 32:1023–1031

    Article  Google Scholar 

  14. Labek G et al (2013) Outcome after total ankle arthroplasty-results and findings from worldwide arthroplasty registers. Int Orthop 37:1677–1682

    Article  Google Scholar 

  15. Ling JS et al (2015) Investigating the relationship between ankle arthrodesis and adjacent-joint arthritis in the hindfoot. A systematic review. J Bone Joint Surg Am 97:e43

    Article  CAS  Google Scholar 

  16. Martin RL et al (2007) Posttraumatic ankle arthritis: an update on conservative and surgical management. J Orthop Sports Phys Ther 37:253–259

    Article  Google Scholar 

  17. Paget LDA et al (2021) Effect of platelet-rich plasma injections vs placebo on ankle symptoms and function in patients with ankle osteoarthritis: a randomized clinical trial. JAMA 326:1595–1605

    Article  CAS  Google Scholar 

  18. Preis M et al (2017) Can a three-component prosthesis be used for conversion of painful ankle arthrodesis to total ankle replacement? Clin Orthop Relat Res 475:2283–2294

    Article  Google Scholar 

  19. Preis M et al (2019) Conversion of painful tibiotalocalcaneal arthrodesis to total ankle replacement using a 3-component mobile bearing prosthesis. Foot Ankle Surg 25:286–293

    Article  Google Scholar 

  20. Rahm S et al (2015) Inferior results of salvage arthrodesis after failed ankle replacement compared to primary arthrodesis. Foot Ankle Int 36:349–359

    Article  Google Scholar 

  21. Raynauld JP et al (2003) Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 48:370–377

    Article  CAS  Google Scholar 

  22. Repetto I et al (2017) Conservative treatment of ankle osteoarthritis: can platelet-rich plasma effectively postpone surgery? J Foot Ankle Surg 56:362–365

    Article  Google Scholar 

  23. Schmid T, Krause FG (2013) Conservative treatment of asymmetric ankle osteoarthritis. Foot Ankle Clin 18:437–448

    Article  Google Scholar 

  24. Singer S et al (2013) Ankle arthroplasty and ankle arthrodesis: gait analysis compared with normal controls. J Bone Joint Surg Am 95:e191(191–110)

    Article  Google Scholar 

  25. Tanaka Y (2012) The concept of ankle joint preserving surgery: why does supramalleolar osteotomy work and how to decide when to do an osteotomy or joint replacement. Foot Ankle Clin 17:545–553

    Article  Google Scholar 

  26. Tanaka Y et al (2006) Low tibial osteotomy for varus-type osteoarthritis of the ankle. J Bone Joint Surg Br 88:909–913

    Article  CAS  Google Scholar 

  27. Townshend D et al (2013) Arthroscopic versus open ankle arthrodesis: a multicenter comparative case series. J Bone Joint Surg Am 95:98–102

    Article  Google Scholar 

  28. Uçkay I et al (2019) Does intra-articular injection of the ankle with corticosteroids increase the risk of subsequent periprosthetic joint infection (PJI) following total ankle arthroplasty (TAA)? If so, how long after a prior intra-articular injection can TAA be safely performed? Foot Ankle Int 40:3s–4s

    Article  Google Scholar 

  29. Valderrabano V et al (2007) J. Leonard Goldner Award 2006. Total ankle replacement in ankle osteoarthritis: an analysis of muscle rehabilitation. Foot Ankle Int 28:281–291

    Article  Google Scholar 

  30. Valderrabano V et al (2007) Gait analysis in ankle osteoarthritis and total ankle replacement. Clin Biomech (Bristol, Avon) 22:894–904

    Article  Google Scholar 

  31. Valderrabano V et al (2013) Joint-preserving surgery of valgus ankle osteoarthritis. Foot Ankle Clin 18:481–502

    Article  Google Scholar 

  32. Veljkovic AN et al (2019) Outcomes of total ankle replacement, arthroscopic ankle arthrodesis, and open ankle arthrodesis for isolated non-deformed end-stage ankle arthritis. J Bone Joint Surg Am 101:1523–1529

    Article  Google Scholar 

  33. Wood PL et al (2008) Total ankle replacement: medium-term results in 200 Scandinavian total ankle replacements. J Bone Joint Surg Br 90:605–609

    Article  CAS  Google Scholar 

  34. Younger AS et al (2015) Patient expectation and satisfaction as measures of operative outcome in end-stage ankle arthritis: a prospective cohort study of total ankle replacement versus ankle fusion. Foot Ankle Int 36:123–134

    Article  Google Scholar 

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Authors and Affiliations

  1. OCW Würzburg, Oeggstr. 3, 97070, Würzburg, Deutschland

    Matthias G. Walcher

  2. Rennbahnklinik, Kriegackerstr. 100, 4132, Muttenz, Schweiz

    Jochen Paul

Authors
  1. Matthias G. Walcher
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  2. Jochen Paul
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Correspondence to Matthias G. Walcher.

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Interessenkonflikt

M.G. Walcher und J. Paul geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Thomas Buchhorn, Straubing

Hans Polzer, München

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Walcher, M.G., Paul, J. Arthrodese vs. Prothese bei endgradiger Arthrose am oberen Sprunggelenk. Unfallchirurg 125, 205–210 (2022). https://doi.org/10.1007/s00113-022-01145-4

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