Subsidence of total ankle component associated with deterioration of an ankle scale in non-inflammatory arthritis but not in rheumatoid arthritis

Abstract

Objectives: Modern three-component total ankle arthroplasty (TAA) has favorable clinical results and survival rates. However, radiographic deterioration and worsening of clinical symptoms may occur in patients with rheumatoid arthritis (RA) or non-inflammatory arthritis (NA). The associations between outcomes and clinical and radiological factors are not clear. We compared midterm clinical and radiographic outcomes after TAA between patients with RA and those with NA.

Methods: Twenty-six TAAs were performed using a three-component prosthesis, the FINE Total Ankle System during the study period. Fourteen TAAs with 11 RA patients undergoing primary TAA were compared with twelve TAAs with 12 NA patients. Clinical and radiographic outcomes were evaluated before and after operation, and at the final follow-up.

Results: The Japanese Society for Surgery of the Foot (JSSF) scale improved significantly following TAA in both groups (p = 0.0039 and 0.0156, respectively). Tibial subsidence, talar subsidence and age were significantly associated with postoperative JSSF score only in the NA group (p = 0.0027, 0.0017 and p < 0.0001, respectively). Stepwise regression analysis showed that talar subsidence was an independent predictor of a worse JSSF score in the NA group (F = 10.3).

Conclusions: The final clinical outcome was negatively influenced by talar subsidence in patients with NA, but not in those with RA.

Keywords:

• Clinical outcome
• Non-inflammatory arthritis
• Radiological outcome
• Rheumatoid arthritis
• Total ankle arthroplasty

Acknowledgements

The authors thank Drs. H. Ogino and Y. Hamamoto Kyoto University Graduate School of Medicine, for valuable help and significant contributions to this article.

Conflict of interest

This work was not supported by any specific funding. M.F. belong to the department that is financially supported by four pharmaceutical companies (Mitsubishi-Tanabe, Chugai, Bristol-Myers, and Eisai). H.I. has received research grant and/or speaker fee from Chugai, Mitsubishi-Tanabe, Pfizer, Bristol-Myers, and Astellas; Takahiro Iwata, Masahiro Ishikawa, Masayuki Azukizawa, Hiroyuki Yoshitomi, Takayuki Fujii, Haruhiko Akiyama and Shuichi Matsuda declared no conflict of interest exists. The sponsors were not involved in the study design; in the collection, analysis, interpretation of data; in the writing of this manuscript; or in the decision to submit the article for publication. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.