인대 불안정성이 동반된 말기 족근 관절염 환자의 자가 인대 재건술과 인공관절 치환술의 치료 결과
End Stage Ankle Arthritis with Ankle Instability Patients Treatment Results Using Autograft Ligament Reconstruction with Total Ankle Arthroplasty
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Purpose: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. Materials and Methods: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. Results: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average 8.2±0.9 (range, 7~10)to 2.7±1.7 (range, 0~6) and the AOFAS score improved from 46.4±14.6 points (range, 23~69) to 80.1±9.3 points (range, 65~95)at final follow-up. Anterior draw test improved 15.2±3.4 mm (range, 12~23 mm) to 8.8±2.6 mm (range, 6~13mm),varus stress test improved from 13.9±4.6° (range,10-18°) to 6.2±4.7° (range,2-18°) at final follow up. Conclusion: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.
Abstract
Purpose: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. Materials and Methods: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. Results: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average 8.2±0.9 (range, 7~10)to 2.7±1.7 (range, 0~6) and the AOFAS score improved from 46.4±14.6 points (range, 23~69) to 80.1±9.3 points (range, 65~95)at final follow-up. Anterior draw test improved 15.2±3.4 mm (range, 12~23 mm) to 8.8±2.6 mm (range, 6~13mm),varus stress test improved from 13.9±4.6° (range,10-18°) to 6.2±4.7° (range,2-18°) at final follow up. Conclusion: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.
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