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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2014 April;65(2):191-8
Mid-term outcomes of ankle, subtalar and mid-foot arthrodesis in rheumatic patients
Bonasia D. E. 1, Bongi L. 1, Tron A. 2, Rossi R. 2, Massa A. D. F. 1, Clerico P. 1, Triolo P. 1 ✉
1 Azienda Ospedaliera Città della Salute e della Scienza, Azienda Ospedaliera CTO, University of Turin, Turin, Italy;
2 Azienda Ospedaliera Mauriziano “Umberto I”, University of Turin, Turin, Italy
AIM: Ankle, subtalar and mid-foot arthrodeses are still considered the gold standard treatment in rheumatic patients with ankle and hindfoot arthritis. The aim of this study was to evaluate the mid-term outcomes of ankle, subtalar and mid-foot arthrodesis in rheumatic patients.
METHODS: In this mid-term retrospective study, patients who received ankle, subtalar and mid-foot arthrodesis due to rheumatic diseases were included. The 28 patients included were administered GH, pain VAS scale, SF-36, DAS 28, and HAQ scales. In addition, the AOFAS hind-foot and mid-foot scores were used. Then the authors investigated the patients’ satisfaction regarding the surgical treatment compared with their expectations before surgery. Finally, the authors compared the group treated with biologics with the group using a standard therapy in order to establish if the use of biologics led to worse results.
RESULTS: The average age of the patients was 61.1 years (SD 10.8). The average follow-up time was 9.8 years (SD 7.9); 85.7% of the patients were affected by rheumatoid arthritis (RA) and 14.3% by psoriatic arthritis (PsA); 64.3% of the patients were treated with biologic medications. Satisfactory scores were obtained for all administered tests. In the comparison between RA and PsA groups, little differences were noted. Indeed, while the stage of pathology was similar between the 2 groups, the PsA group showed a lower degree of disability (P=0.005) and pain (P=0.032) even if the AOFAS scores were not statistically different.
CONCLUSION: We can conclude that ankle and hindfoot arthrodeses produce good functional results and good patient satisfaction at mid-term follow-up for the treatment of arthritis in rheumatic conditions. The use biologics, if correctly managed, is not a contraindication to this type of surgery.