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  • Talk
  • 23/06/2023
  • CANADA

Long Term Results of Total Ankle Replacement vs Ankle Arthrodesis - A Follow-Up COFAS Study

Description

In this presentation delivered by Mark Glazebrook, the long-term results of a study on ankle arthroplasty versus arthrodesis are discussed. The study commenced in 2003, with the aim of investigating whether total ankle arthroplasty has an effective role compared to the traditional ankle fusion method. Glazebrook highlights that previous data showed similar health-related quality of life outcomes for patients with ankle and hip arthritis. A prospective study was conducted between 2001 and 2007, although it lacked randomization, focusing on patients who received either ankle fusion or replacement based on consensus with their surgeons.



Key findings reveal that the clinical outcomes over the years demonstrated that both surgical options yield similar effectiveness, but the long-term results indicate significant differences in reoperation rates. Ankle fusions generally had fewer complications related to reoperations, primarily revolving around hardware removal, while total ankle replacements showed higher rates of reoperation, often associated with debridement procedures rather than complete revisions.



In examining patients' data, variables such as age, smoking history, and inflammatory arthritis were found to differ across the two groups, impacting the clinical outcome scores. Ultimately, adjusted comparisons showed no significant difference in clinical outcomes between the two methods when accounting for these variables.



Additionally, the presentation addresses survival data, noting that failure rates for total ankle replacements increase over time, leading to more discussions around their viability compared to arthrodesis. Glazebrook acknowledges the limitations of the study as it is level II data, emphasizing that better data from future studies, including a comprehensive trial from the British Orthopedic Foot and Ankle Society, may provide additional insights. Glazebrook encourages awareness that while clinical outcomes might appear favorable for ankle replacements, the data suggests a need for caution due to higher reoperation and failure rates in the long term.

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