Most patients who undergo a total ankle arthroplasty are able to resume their sports activities at presurgical levels, an observational study has found.
Of the 101 patients surveyed, 62% were active in sports before surgery and 66% after surgery; these patients participated in the same number of recreational activities at the same or at a slightly increased activity level, Dr. Florian D. Naal and his colleagues reported in the American Journal of Sports Medicine.
Dr. Naal of the Schulthess Clinic, Zurich, and his coauthors attributed the favorable outcomes to the new generation of three-component, porous-coated, mobile-bearing implants, which have renewed interest in this procedure, especially among younger patients.
The authors surveyed 101 of their patients who underwent total ankle arthroplasty from 2002 to 2005. The patients' mean age at surgery was 59 years (range, 24–87 years). The primary diagnoses were posttraumatic ankle osteoarthritis (46%), primary ankle osteoarthritis (35%), and inflammatory ankle arthritis (19%). The mean follow-up was 44 months.
Ten patients stopped their activities after surgery, while 14 who were inactive beforehand took up a sport afterward. Patients who kept playing sports engaged in the same number of sports before and after surgery (mean of three), and actually devoted somewhat more time after surgery (mean 4.7 hours vs. 4 hours). The 20% difference was not statistically significant, however (Am. J. Sports Med. 2009;37:95–102).
According to the University of California, Los Angeles, activity scale, activity levels increased significantly after surgery, rising from a score of 4 to 6. Patients who had inflammatory osteoarthritis were the least active, while those with primary ankle osteoarthritis were the most active, although this difference was not significant.
When surveyed about surgical satisfaction on a visual analog scale of 1–10, patients rated their surgery as satisfactory, with a mean score of 8. The mean pain level during sports was 3; 63% of the group was satisfied with the level of postsurgical sports activity.
The American Orthopedic Foot and Ankle Score improved significantly after surgery, from a mean of 45 to a mean of 84. Tibial radiolucencies were observed in 35% of patents, and radiolucencies around the talar component in 8%.
The authors declared they had no potential conflicts of interest relevant to the study.