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Prolonged clinical benefit from joint distraction in the treatment of ankle osteoarthritis.

Abstract：

OBJECTIVE:Osteoarthritis (OA) is a degenerative disabling joint disease affecting more than 10% of the adult population. No validated disease-modifying treatment is available. Joint distraction is a relatively new approach to the treatment of severe ankle OA. Short-term (3 years) clinical benefit has been proven, but long-term effects remain to be evaluated. METHODS:Patients with severe OA of the tibio-talar joint, who had been treated with Ilizarov joint distraction more than 7 years previously, were included. Pre-treatment data were obtained by retrospective analysis using questionnaires and patients' charts. Post-treatment assessments were undertaken using the same questionnaires and by physical examination. Three approaches were used and results were compared: the van Valburg score, the Ankle Osteoarthritis Scale (AOS), and a patient satisfaction questionnaire. Retrospectively and prospectively obtained data were available from eight patients for comparison. RESULTS:Twenty-five out of 27 patients with severe ankle OA treated with Ilizarov joint distraction could be traced. Appropriate retrospective data could not be obtained from three patients. Six out of the 22 patients (27%) were failures. In 16 patients (73%), significant improvement in all clinical parameters was observed using each of the three approaches. Good correlations were found between the results of the three methods of assessment and retrospectively obtained pre-treatment values were very similar to the prospective data. CONCLUSIONS:In 73% of the patients, significant clinical benefit from joint distraction of severe OA ankles was maintained for at least 7 years. There is, however, a need for further research to try and predict which patients will not respond to this unconventional form of major surgical intervention.

journal_name

Osteoarthritis Cartilage

journal_title

Osteoarthritis and cartilage

authors

Ploegmakers JJ,van Roermund PM,van Melkebeek J,Lammens J,Bijlsma JW,Lafeber FP,Marijnissen AC

doi

10.1016/j.joca.2005.03.002

keywords:

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

582-8

issue

eissn

1063-4584

issn

1522-9653

pii

S1063-4584(05)00075-0

journal_volume

pub_type

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Prolonged clinical benefit from joint distraction in the treatment of ankle osteoarthritis.