The Effect of Tibiotalar Joint Line Level Alterations on Tibiotalar Range of Motion Following Total Ankle Arthroplasty
BACKGROUND: The effect of tibiotalar joint line level (TTJL) on patient outcomes following total ankle arthroplasty (TAA) remains unclear. It was previously reported that patients with end-stage ankle arthritis have an elevated TTJL compared with nonarthritic ankles, and the TTJL post-TAA remains elevated compared with nonarthritic ankles. The objectives of this study were to (1) propose a reliable radiographic method to measure the TTJL absolute value and (2) determine the effect of TTJL alterations on tibiotalar range of motion (ROM) following TAA.
METHODS: A retrospective review was performed on patients who underwent TAA between January 2018 and April 2021 with a minimum of 1-year postoperative follow-up and complete perioperative ROM radiographs. Radiographic TTJL and ROM measurements were performed by 2 observers. The proposed TTJL measuring technique computes 4 measurements: high, low, center of the talus (center), and center of the axis (axis). Reliability of measurements and correlation between TTJL measurements and ROM were assessed.
RESULTS: A total of 33 patients were included. Postoperatively, 22 patients had a lowered TTJL compared to 11 patients with an elevated TTJL (2.2 ± 1.3 mm lowered vs 1.9 ± 1.2 mm elevated; P < .0001). Of the 4 TTJL measurements, 3 (low, center, axis) demonstrated a significant positive correlation between lowering the TTJL and improved tibiotalar dorsiflexion and 2 (low, axis) for total ROM (all P < .05). Plantarflexion was not significantly affected by TTJL alterations. Compared to patients with an elevated TTJL, patients with a lowered TTJL had improved tibiotalar dorsiflexion (8.8 vs 2.5 degrees; P = .0015) and total ROM (31.0 vs 22.9 degrees; P = .0191), respectively. The interrater reliability was nearly perfect (intraclass correlation r = 0.96-0.99).
CONCLUSION: In this small series, we found that lowering the TTJL level may more closely reestablish the native TTJL and correlates with improved tibiotalar dorsiflexion and total ROM following TAA.
LEVEL OF EVIDENCE: Level IV, case series.
| Errataetall: |
CommentOn: Foot Ankle Orthop. 2019 Dec 06;4(4):2473011419884359. - PMID 35097348 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
|---|---|
| Enthalten in: |
Foot & ankle international - 45(2024), 1 vom: 01. Jan., Seite 20-29 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Fletcher, Amanda N [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Ankle |
|---|
| Anmerkungen: |
Date Completed 29.01.2024 Date Revised 14.02.2024 published: Print-Electronic CommentOn: Foot Ankle Orthop. 2019 Dec 06;4(4):2473011419884359. - PMID 35097348 Citation Status MEDLINE |
|---|
| doi: |
10.1177/10711007231199963 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM363772758 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM363772758 | ||
| 003 | DE-627 | ||
| 005 | 20240215231925.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/10711007231199963 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1294.xml |
| 035 | |a (DE-627)NLM363772758 | ||
| 035 | |a (NLM)37885203 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Fletcher, Amanda N |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Effect of Tibiotalar Joint Line Level Alterations on Tibiotalar Range of Motion Following Total Ankle Arthroplasty |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.01.2024 | ||
| 500 | |a Date Revised 14.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentOn: Foot Ankle Orthop. 2019 Dec 06;4(4):2473011419884359. - PMID 35097348 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: The effect of tibiotalar joint line level (TTJL) on patient outcomes following total ankle arthroplasty (TAA) remains unclear. It was previously reported that patients with end-stage ankle arthritis have an elevated TTJL compared with nonarthritic ankles, and the TTJL post-TAA remains elevated compared with nonarthritic ankles. The objectives of this study were to (1) propose a reliable radiographic method to measure the TTJL absolute value and (2) determine the effect of TTJL alterations on tibiotalar range of motion (ROM) following TAA | ||
| 520 | |a METHODS: A retrospective review was performed on patients who underwent TAA between January 2018 and April 2021 with a minimum of 1-year postoperative follow-up and complete perioperative ROM radiographs. Radiographic TTJL and ROM measurements were performed by 2 observers. The proposed TTJL measuring technique computes 4 measurements: high, low, center of the talus (center), and center of the axis (axis). Reliability of measurements and correlation between TTJL measurements and ROM were assessed | ||
| 520 | |a RESULTS: A total of 33 patients were included. Postoperatively, 22 patients had a lowered TTJL compared to 11 patients with an elevated TTJL (2.2 ± 1.3 mm lowered vs 1.9 ± 1.2 mm elevated; P < .0001). Of the 4 TTJL measurements, 3 (low, center, axis) demonstrated a significant positive correlation between lowering the TTJL and improved tibiotalar dorsiflexion and 2 (low, axis) for total ROM (all P < .05). Plantarflexion was not significantly affected by TTJL alterations. Compared to patients with an elevated TTJL, patients with a lowered TTJL had improved tibiotalar dorsiflexion (8.8 vs 2.5 degrees; P = .0015) and total ROM (31.0 vs 22.9 degrees; P = .0191), respectively. The interrater reliability was nearly perfect (intraclass correlation r = 0.96-0.99) | ||
| 520 | |a CONCLUSION: In this small series, we found that lowering the TTJL level may more closely reestablish the native TTJL and correlates with improved tibiotalar dorsiflexion and total ROM following TAA | ||
| 520 | |a LEVEL OF EVIDENCE: Level IV, case series | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Comment | |
| 650 | 4 | |a ankle | |
| 650 | 4 | |a joint line | |
| 650 | 4 | |a joint line alterations | |
| 650 | 4 | |a joint line elevation | |
| 650 | 4 | |a joint line level | |
| 650 | 4 | |a range of motion | |
| 650 | 4 | |a tibiotalar | |
| 650 | 4 | |a total ankle arthroplasty | |
| 650 | 4 | |a total ankle replacement | |
| 700 | 1 | |a Campbell, John T |e verfasserin |4 aut | |
| 700 | 1 | |a Maloney, Patrick J |e verfasserin |4 aut | |
| 700 | 1 | |a Cerrato, Rebecca A |e verfasserin |4 aut | |
| 700 | 1 | |a Jeng, Clifford L |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Foot & ankle international |d 1997 |g 45(2024), 1 vom: 01. Jan., Seite 20-29 |w (DE-627)NLM075077000 |x 1944-7876 |7 nnns |
| 773 | 1 | 8 | |g volume:45 |g year:2024 |g number:1 |g day:01 |g month:01 |g pages:20-29 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/10711007231199963 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 45 |j 2024 |e 1 |b 01 |c 01 |h 20-29 | ||