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Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları

Year 2021, Volume 7, Issue 2, 154 - 159, 29.05.2021
https://doi.org/10.30934/kusbed.882182

Abstract

Amaç: Bu çalışmada, ayak bileği artrozu tanısı ile üç farklı yaklaşımla opere edilen hastaların uzun dönem klinik fonksiyonel sonuçlarını değerlendirmeyi amaçladık. Yöntem: 2002-2013 tarihleri arasında opere edilen 49 olgu retrospektif olarak değerlendirildi. İlizarov tekniği ile artrodez yapılan hastalar İABA grubu (n:8) olarak isimlendirildi. Vida ile artrodez yapılan hastalar VABA grubu (n:25) olarak isimlendirildi. Kalkaneotalotibial çivi ile artrodez yapılan hastalar ise KABA grubu (n:16) olarak isimlendirildi. Gruplar; hastane yatış süresi, cerrahi süre, komplikasyon oranı, preoperatif ve postoperatif görsel analog ölçeği (Visual Analogue Scale; VAS) ve postoperatif Maryland ayak skoru açısından değerlendirildi. Bulgular: Gruplara göre preoperatif VAS değerlendirilmesinde anlamlı bir farklılık gözlemlenmedi (p=0,452). İABA grubunda VAS diğer iki gruba göre anlamlı düzeyde düşük olarak gözlemlendi (p=0,01). Gruplara göre Maryland ayak skoru değerlendirmesinde anlamlı bir farklılık gözlemlenmedi (p=0,145). İABA grubunda diğer iki gruba göre daha fazla komplikasyon gözlemlenmiştir. KABA grubunda diğer iki gruba göre daha az komplikasyon gözlemlendi (p=0,004). Sonuç: İABA grubunda, diğer gruplara göre VAS daha az olarak bulundu fakat daha yüksek komplikasyon oranı gözlemlendi. KABA grubunda diğer iki gruplara göre daha az komplikasyon oranı gözlemlendi. Postoperatif Maryland ayak skoru açısından; göre gruplar arasında farklılık gözlemlenmedi.

References

  • Moskowitz RW, Altman RD, Hochberg MC, Buckwalter JA, Goldberg VM (Editors). Osteoarthritis. In: Michelson J. Lower extremity considerations: foot and ankle. 4th ed. Philadelphia, Lippincott Williams & Wilkins: 2006: 215-26.
  • Yılmaz B, Kömür B, Heybeli N. Ayak bileği sorunları ve rejeneratif tedavi yöntemleri. Türkiye Klinikleri J Orthop &Traumatol-Special Topics 2013;6(1):40-9.
  • Valderrabano V, Nigg BM, von Tscharner V, Stefanyshyn DJ, Goepfert B, Hintermann B. Gait analysis in ankle osteoarthritis and total ankle replacement. Clin Biomech (Bristol, Avon). 2007;22(8):894-904.doi: 10.1016/j.clinbiomech.2007.05.003.
  • Valderrabano V, Horisberger M, Russell I, Dougall H, Hintermann B. Etiology of ankle osteoarthritis. Clin Orthop Relat Res. 2009;467(7):1800-1806. doi: 10.1007/s11999-008-0543-6.
  • Yilmaz B, Kömür B, Özdemir G, Heybeli N. Ankle arthroplasty in a patient with bleeding diathesis and the mid-term clinical outcome of the case. Ann Med Surg (Lond). 2015;4(4):404-406. doi: 10.1016/j.amsu.2015.09.003.
  • Thomas RH, Daniels TR. Ankle arthritis. J Bone Joint Surg Am. 2003;85(5):923-936. doi: 10.2106/00004623-200305000-00026.
  • Helm R. The results of ankle arthrodesis. J Bone Joint Surg Br. 1990;72(1):141-143.doi:10.1302/0301-620X.72B1.2298774.
  • Dennis DA, Clayton ML, Wong DA, Marc RP, Susman MH. Internal fixation compression arthrodesis of the ankle. Clin Orthop 1990;253:212-20.
  • Fragomen AT, Borst E, Schachter L, Lyman S, Rozbruch SR. Complex ankle arthrodesis using the Ilizarov method yields high rate of fusion. Clin Orthop Relat Res. 2012;470(10):2864-2873. doi: 10.1007/s11999-012-2470-9.
  • Chahal J, Stephen DJ, Bulmer B, Daniels T, Kreder HJ. Factors associated with outcome after subtalar arthrodesis. J Orthop Trauma. 2006;20(8):555-561.doi: 10.1097/01.bot.0000211156.13487.6a.
  • Morasiewicz P, Dejnek M, Orzechowski W, et al. Clinical evaluation of ankle arthrodesis with Ilizarov fixation and internal fixation. BMC Musculoskelet Disord. 2019;20(1):167. doi: 10.1186/s12891-019-2524-1.
  • Rabinovich RV, Haleem AM, Rozbruch SR. Complex ankle arthrodesis: Review of the literature. World J Orthop. 2015;6(8):602-613. doi: 10.5312/wjo.v6.i8.602.
  • Morasiewicz P, Dejnek M, Urbański W, Dragan SŁ, Kulej M, Dragan SF. Radiological evaluation of ankle arthrodesis with Ilizarov fixation compared to internal fixation. Injury. 2017;48(7):1678-1683. doi: 10.1016/j.injury.2017.04.013.
  • Tornetta P 3rd, Qadir R, Sanders R. Pain dominates summed scores for hindfoot and ankle trauma. J Orthop Trauma. 2013;27(8):477-482. doi: 10.1097/BOT.0b013e31827973b3.
  • Katsenis D, Bhave A, Paley D, Herzenberg JE. Treatment of malunion and nonunion at the site of an ankle fusion with the Ilizarov apparatus. J Bone Joint Surg Am. 2005;87(2):302-309. doi: 10.2106/JBJS.C.01421.
  • Salem KH, Kinzl L, Schmelz A. Ankle arthrodesis using Ilizarov ring fixators: a review of 22 cases. Foot Ankle Int. 2006 Oct;27(10):764-70. doi: 10.1177/107110070602701002.
  • Hoover JR, Santrock RD, James WC 3rd. Ankle fusion stability: a biomechanical comparison of external versus internal fixation. Orthopedics. 2011 Apr 11;34(4). doi: 10.3928/01477447-20110228-04.
  • Tellisi N, Fragomen AT, Ilizarov S, Rozbruch SR. Limb salvage reconstruction of the ankle with fusion and simultaneous tibial lengthening using the Ilizarov/Taylor spatial frame. HSS J. 2008;4(1):32-42. doi: 10.1007/s11420-007-9073-0.
  • Anderson T, Maxander P, Rydholm U, Besjakov J, Carlsson A. Ankle arthrodesis by compression screws in rheumatoid arthritis: primary nonunion in 9/35 patients. Acta Orthop. 2005 Dec;76(6):884-90. doi: 10.1080/17453670510045543.
  • Hendrickx RP, Stufkens SA, de Bruijn EE, Sierevelt IN, van Dijk CN, Kerkhoffs GM. Medium- to long-term outcome of ankle arthrodesis. Foot Ankle Int. 2011;32(10):940-947. doi: 10.3113/FAI.2011.0940.
  • Zwipp H, Rammelt S, Endres T, Heineck J. High union rates and function scores at midterm followup with ankle arthrodesis using a four screw technique. Clin Orthop Relat Res. 2010;468(4):958-968. doi: 10.1007/s11999-009-1074-5.
  • Baumbach SF, Massen FK, Hörterer S, et al. Comparison of arthroscopic to open tibiotalocalcaneal arthrodesis in high-risk patients. Foot Ankle Surg. 2019;25(6):804-811.doi: 10.1016/j.fas.2018.10.006.
  • Griffin MJ, Coughlin MJ. Evaluation of Midterm Results of the Panta Nail: An Active Compression Tibiotalocalcaneal Arthrodesis Device. J Foot Ankle Surg. 2018;57(1):74-80. doi: 10.1053/j.jfas.2017.08.010.
  • Bennett GL, Cameron B, Njus G, Saunders M, Kay DB. Tibiotalocalcaneal arthrodesis: a biomechanical assessment of stability. Foot Ankle Int. 2005 Jul;26(7):530-6.doi: 10.1177/107110070502600706.
  • Dujela M, Hyer CF, Berlet GC. Rate of Subtalar Joint Arthrodesis After Retrograde Tibiotalocalcaneal Arthrodesis With Intramedullary Nail Fixation: Evaluation of the RAIN Database. Foot Ankle Spec. 2018;11(5):410-415.doi: 10.1177/1938640017740674.
  • Biz C, Hoxhaj B, Aldegheri R, Iacobellis C. Minimally Invasive Surgery for Tibiotalocalcaneal Arthrodesis Using a Retrograde Intramedullary Nail: Preliminary Results of an Innovative Modified Technique. J Foot Ankle Surg. 2016;55(6):1130-1138. doi: 10.1053/j.jfas.2016.06.002.
  • Lucas Y Hernandez J, Abad J, Remy S, Darcel V, Chauveaux D, Laffenetre O. Tibiotalocalcaneal arthrodesis using a straight intramedullary nail. Foot Ankle Int. 2015;36(5):539-546. doi: 10.1177/1071100714565900.
  • Zhang C, Shi Z, Mei G. Locking plate versus retrograde intramedullary nail fixation for tibiotalocalcaneal arthrodesis: A retrospective analysis. Indian J Orthop. 2015;49(2):227-232. doi: 10.4103/0019-5413.152492.
  • Sener M, Onar V, Kazlmoğlu C, Yağdi S. Parsiyel protez ile tedavi edilen yaşli femur ust uç kiriklarinda mortalite ve morbidite ilişkisi [Mortality and morbidity in elderly patients who underwent partial prosthesis replacement for proximal femoral fractures]. Eklem Hastalik Cerrahisi. 2009;20(1):11-17.

Long-term Results of Three Different Techniques in Ankle Arthrodesis

Year 2021, Volume 7, Issue 2, 154 - 159, 29.05.2021
https://doi.org/10.30934/kusbed.882182

Abstract

Aim: In this study, we aimed to evaluate the long-term clinical functional results of patients who were operated with the diagnosis of ankle arthrosis with three different techniques. Methods: 49 cases who were operated between 2002 and 2013 were evaluated retrospectively. The patients who underwent arthrodesis with Ilizarov technique were evaluated as IABA group (n: 8). The patients who underwent arthrodesis with screws were evaluated as VABA group (n: 25). The patients who underwent arthrodesis with the calcaneotalotibial nail were evaluated as KABA group (n: 16). Duration of hospitalization, duration of surgery, complication rates, preoperative and postoperative visual analog scales (VAS), and postoperative Maryland foot scores were evaluated. Results: No significant difference was observed in the preoperative evaluation of VAS according to the groups (p= 0.452). It was observed that the VAS of the IABA group was significantly lower than the other two groups (p= 0.01). No significant difference was observed in Maryland foot score evaluation according to the groups (p= 0.145). More complication rates were observed in the IABA group compared to the other two groups. Less complication rates were observed in the KABA group compared to the other two groups (p= 0.004). Conclusion: It was observed that VAS was less in the IABA group compared to other groups, but the IABA group had higher complication rates. A lower complication rate was observed in the KABA group compared to the other other groups. There was no difference between the groups according to the Maryland foot score.

References

  • Moskowitz RW, Altman RD, Hochberg MC, Buckwalter JA, Goldberg VM (Editors). Osteoarthritis. In: Michelson J. Lower extremity considerations: foot and ankle. 4th ed. Philadelphia, Lippincott Williams & Wilkins: 2006: 215-26.
  • Yılmaz B, Kömür B, Heybeli N. Ayak bileği sorunları ve rejeneratif tedavi yöntemleri. Türkiye Klinikleri J Orthop &Traumatol-Special Topics 2013;6(1):40-9.
  • Valderrabano V, Nigg BM, von Tscharner V, Stefanyshyn DJ, Goepfert B, Hintermann B. Gait analysis in ankle osteoarthritis and total ankle replacement. Clin Biomech (Bristol, Avon). 2007;22(8):894-904.doi: 10.1016/j.clinbiomech.2007.05.003.
  • Valderrabano V, Horisberger M, Russell I, Dougall H, Hintermann B. Etiology of ankle osteoarthritis. Clin Orthop Relat Res. 2009;467(7):1800-1806. doi: 10.1007/s11999-008-0543-6.
  • Yilmaz B, Kömür B, Özdemir G, Heybeli N. Ankle arthroplasty in a patient with bleeding diathesis and the mid-term clinical outcome of the case. Ann Med Surg (Lond). 2015;4(4):404-406. doi: 10.1016/j.amsu.2015.09.003.
  • Thomas RH, Daniels TR. Ankle arthritis. J Bone Joint Surg Am. 2003;85(5):923-936. doi: 10.2106/00004623-200305000-00026.
  • Helm R. The results of ankle arthrodesis. J Bone Joint Surg Br. 1990;72(1):141-143.doi:10.1302/0301-620X.72B1.2298774.
  • Dennis DA, Clayton ML, Wong DA, Marc RP, Susman MH. Internal fixation compression arthrodesis of the ankle. Clin Orthop 1990;253:212-20.
  • Fragomen AT, Borst E, Schachter L, Lyman S, Rozbruch SR. Complex ankle arthrodesis using the Ilizarov method yields high rate of fusion. Clin Orthop Relat Res. 2012;470(10):2864-2873. doi: 10.1007/s11999-012-2470-9.
  • Chahal J, Stephen DJ, Bulmer B, Daniels T, Kreder HJ. Factors associated with outcome after subtalar arthrodesis. J Orthop Trauma. 2006;20(8):555-561.doi: 10.1097/01.bot.0000211156.13487.6a.
  • Morasiewicz P, Dejnek M, Orzechowski W, et al. Clinical evaluation of ankle arthrodesis with Ilizarov fixation and internal fixation. BMC Musculoskelet Disord. 2019;20(1):167. doi: 10.1186/s12891-019-2524-1.
  • Rabinovich RV, Haleem AM, Rozbruch SR. Complex ankle arthrodesis: Review of the literature. World J Orthop. 2015;6(8):602-613. doi: 10.5312/wjo.v6.i8.602.
  • Morasiewicz P, Dejnek M, Urbański W, Dragan SŁ, Kulej M, Dragan SF. Radiological evaluation of ankle arthrodesis with Ilizarov fixation compared to internal fixation. Injury. 2017;48(7):1678-1683. doi: 10.1016/j.injury.2017.04.013.
  • Tornetta P 3rd, Qadir R, Sanders R. Pain dominates summed scores for hindfoot and ankle trauma. J Orthop Trauma. 2013;27(8):477-482. doi: 10.1097/BOT.0b013e31827973b3.
  • Katsenis D, Bhave A, Paley D, Herzenberg JE. Treatment of malunion and nonunion at the site of an ankle fusion with the Ilizarov apparatus. J Bone Joint Surg Am. 2005;87(2):302-309. doi: 10.2106/JBJS.C.01421.
  • Salem KH, Kinzl L, Schmelz A. Ankle arthrodesis using Ilizarov ring fixators: a review of 22 cases. Foot Ankle Int. 2006 Oct;27(10):764-70. doi: 10.1177/107110070602701002.
  • Hoover JR, Santrock RD, James WC 3rd. Ankle fusion stability: a biomechanical comparison of external versus internal fixation. Orthopedics. 2011 Apr 11;34(4). doi: 10.3928/01477447-20110228-04.
  • Tellisi N, Fragomen AT, Ilizarov S, Rozbruch SR. Limb salvage reconstruction of the ankle with fusion and simultaneous tibial lengthening using the Ilizarov/Taylor spatial frame. HSS J. 2008;4(1):32-42. doi: 10.1007/s11420-007-9073-0.
  • Anderson T, Maxander P, Rydholm U, Besjakov J, Carlsson A. Ankle arthrodesis by compression screws in rheumatoid arthritis: primary nonunion in 9/35 patients. Acta Orthop. 2005 Dec;76(6):884-90. doi: 10.1080/17453670510045543.
  • Hendrickx RP, Stufkens SA, de Bruijn EE, Sierevelt IN, van Dijk CN, Kerkhoffs GM. Medium- to long-term outcome of ankle arthrodesis. Foot Ankle Int. 2011;32(10):940-947. doi: 10.3113/FAI.2011.0940.
  • Zwipp H, Rammelt S, Endres T, Heineck J. High union rates and function scores at midterm followup with ankle arthrodesis using a four screw technique. Clin Orthop Relat Res. 2010;468(4):958-968. doi: 10.1007/s11999-009-1074-5.
  • Baumbach SF, Massen FK, Hörterer S, et al. Comparison of arthroscopic to open tibiotalocalcaneal arthrodesis in high-risk patients. Foot Ankle Surg. 2019;25(6):804-811.doi: 10.1016/j.fas.2018.10.006.
  • Griffin MJ, Coughlin MJ. Evaluation of Midterm Results of the Panta Nail: An Active Compression Tibiotalocalcaneal Arthrodesis Device. J Foot Ankle Surg. 2018;57(1):74-80. doi: 10.1053/j.jfas.2017.08.010.
  • Bennett GL, Cameron B, Njus G, Saunders M, Kay DB. Tibiotalocalcaneal arthrodesis: a biomechanical assessment of stability. Foot Ankle Int. 2005 Jul;26(7):530-6.doi: 10.1177/107110070502600706.
  • Dujela M, Hyer CF, Berlet GC. Rate of Subtalar Joint Arthrodesis After Retrograde Tibiotalocalcaneal Arthrodesis With Intramedullary Nail Fixation: Evaluation of the RAIN Database. Foot Ankle Spec. 2018;11(5):410-415.doi: 10.1177/1938640017740674.
  • Biz C, Hoxhaj B, Aldegheri R, Iacobellis C. Minimally Invasive Surgery for Tibiotalocalcaneal Arthrodesis Using a Retrograde Intramedullary Nail: Preliminary Results of an Innovative Modified Technique. J Foot Ankle Surg. 2016;55(6):1130-1138. doi: 10.1053/j.jfas.2016.06.002.
  • Lucas Y Hernandez J, Abad J, Remy S, Darcel V, Chauveaux D, Laffenetre O. Tibiotalocalcaneal arthrodesis using a straight intramedullary nail. Foot Ankle Int. 2015;36(5):539-546. doi: 10.1177/1071100714565900.
  • Zhang C, Shi Z, Mei G. Locking plate versus retrograde intramedullary nail fixation for tibiotalocalcaneal arthrodesis: A retrospective analysis. Indian J Orthop. 2015;49(2):227-232. doi: 10.4103/0019-5413.152492.
  • Sener M, Onar V, Kazlmoğlu C, Yağdi S. Parsiyel protez ile tedavi edilen yaşli femur ust uç kiriklarinda mortalite ve morbidite ilişkisi [Mortality and morbidity in elderly patients who underwent partial prosthesis replacement for proximal femoral fractures]. Eklem Hastalik Cerrahisi. 2009;20(1):11-17.

Details

Primary Language Turkish
Subjects Orthopedics
Journal Section Original Article / Medical Sciences
Authors

Nazim KARAHAN> (Primary Author)
TEKİRDAĞ ÇORLU DEVLET HASTANESİ
0000-0003-0322-5515
Türkiye


Ahmet ÖZTERMELİ>
Kocaeli Gebze Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği
0000-0002-0296-2559
Türkiye


Barış YILMAZ>
İSTANBUL FATİH SULTAN MEHMET SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0003-2023-267X
Türkiye


Nurettin HEYBELİ This is me
NAMIK KEMAL ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-7822-8409
Türkiye

Publication Date May 29, 2021
Application Date February 17, 2021
Acceptance Date May 2, 2021
Published in Issue Year 2021, Volume 7, Issue 2

Cite

Bibtex @research article { kusbed882182, journal = {Kocaeli Üniversitesi Sağlık Bilimleri Dergisi}, eissn = {2149-8571}, address = {yy.kosbildergi@gmail.com}, publisher = {Kocaeli University}, year = {2021}, volume = {7}, number = {2}, pages = {154 - 159}, doi = {10.30934/kusbed.882182}, title = {Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları}, key = {cite}, author = {Karahan, Nazim and Öztermeli, Ahmet and Yılmaz, Barış and Heybeli, Nurettin} }
APA Karahan, N. , Öztermeli, A. , Yılmaz, B. & Heybeli, N. (2021). Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları . Kocaeli Üniversitesi Sağlık Bilimleri Dergisi , 7 (2) , 154-159 . DOI: 10.30934/kusbed.882182
MLA Karahan, N. , Öztermeli, A. , Yılmaz, B. , Heybeli, N. "Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları" . Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 7 (2021 ): 154-159 <https://dergipark.org.tr/en/pub/kusbed/issue/62558/882182>
Chicago Karahan, N. , Öztermeli, A. , Yılmaz, B. , Heybeli, N. "Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları". Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 7 (2021 ): 154-159
RIS TY - JOUR T1 - Long-term Results of Three Different Techniques in Ankle Arthrodesis AU - NazimKarahan, AhmetÖztermeli, BarışYılmaz, NurettinHeybeli Y1 - 2021 PY - 2021 N1 - doi: 10.30934/kusbed.882182 DO - 10.30934/kusbed.882182 T2 - Kocaeli Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 154 EP - 159 VL - 7 IS - 2 SN - -2149-8571 M3 - doi: 10.30934/kusbed.882182 UR - https://doi.org/10.30934/kusbed.882182 Y2 - 2021 ER -
EndNote %0 Kocaeli Üniversitesi Sağlık Bilimleri Dergisi Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları %A Nazim Karahan , Ahmet Öztermeli , Barış Yılmaz , Nurettin Heybeli %T Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları %D 2021 %J Kocaeli Üniversitesi Sağlık Bilimleri Dergisi %P -2149-8571 %V 7 %N 2 %R doi: 10.30934/kusbed.882182 %U 10.30934/kusbed.882182
ISNAD Karahan, Nazim , Öztermeli, Ahmet , Yılmaz, Barış , Heybeli, Nurettin . "Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları". Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 7 / 2 (May 2021): 154-159 . https://doi.org/10.30934/kusbed.882182
AMA Karahan N. , Öztermeli A. , Yılmaz B. , Heybeli N. Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları. KOU Sag Bil Derg. 2021; 7(2): 154-159.
Vancouver Karahan N. , Öztermeli A. , Yılmaz B. , Heybeli N. Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi. 2021; 7(2): 154-159.
IEEE N. Karahan , A. Öztermeli , B. Yılmaz and N. Heybeli , "Ayak Bileği Artrodezinde Farklı Üç Tekniğin Uzun Dönemli Sonuçları", Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, vol. 7, no. 2, pp. 154-159, May. 2021, doi:10.30934/kusbed.882182