Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.7)
Index Copernicus  – 161.11; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 5, May, p. 609–614

doi: 10.17219/acem/80258

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Sport and physical activity after ankle arthrodesis with Ilizarov fixation and internal fixation

Piotr Morasiewicz1,A,B,C,D,E,F, Maciej Dejnek1,A,B,C,D,E,F, Mirosław Kulej1,A,D,E,F, Szymon Ł. Dragan1,A,D,E,F, Grzegorz Konieczny2,A,D,E,F, Artur Krawczyk1,A,D,E,F, Wiktor Urbański1,A,D,E,F, Wiktor Orzechowski1,A,D,E,F, Szymon F. Dragan1,A,D,E,F, Łukasz Pawik3,A,D,E,F

1 Department and Clinic of Orthopaedic and Traumatologic Surgery, Faculty of Medicine, Wroclaw Medical University, Poland

2 Faculty of Health Sciences and Physical Education, Witelon State University of Applied Sciences in Legnica, Poland

3 Department of Physiotherapy and Occupational Therapy in Motor Disorders and Dysfunctions, University School of Physical Education in Wroclaw, Poland

Abstract

Background. Severe osteoarthritis (OA) of the ankle joint constitutes an important social problem.
Objectives. We used (1) the GRIMBY scale, (2) the LOWER LIMB Activity scale, (3) the UCLA (University of California Los Angeles) activity scale, (4) the VAS (visual analogue scale) ACTIVITY scale, and (5) the FAAM (foot and ankle ability measure) SPORT scale to verify whether the type of ankle joint arthrodesis stabilization affected sports and physical activity levels.
Material and Methods. We carried out a prospective clinical study of 47 patients who had undergone ankle arthrodesis with Ilizarov external fixator stabilization (Group 1, n = 21) or internal stabilization with screws (Group 2, n = 26) at Orthopaedic Clinic at the Wroclaw Medical University, Poland, from 2007 to 2015. Sports and physical activity levels were measured by (1) the GRIMBY scale, (2) the LOWER LIMB Activity scale, (3) the UCLA activity scale, (4) the VAS ACTIVITY scale, and (5) the FAAM SPORT scale.
Results. A comparison between the average results of Group 1 and Group 2 on the LOWER LIMB Activity scale and the GRIMBY scale before and after surgery revealed no significant differences. In Group 1, the mean scores on the VAS ACTIVITY scale and the UCLA activity scale after treatment were higher than in Group 2. In Group 1, the mean outcome in the SPORT FAAM scale after treatment was 40; in Group 2 it was 30.06.
Conclusion. Ilizarov fixation of ankle arthrodesis is associated with better scores on the FAAM SPORT, UCLA activity and VAS ACTIVITY scales after treatment than internal fixation. The scores on the GRIMBY scale and the UCLA activity scale were significantly higher after treatment than before treatment in both groups. In this study, ankle fusion with Ilizarov fixation and internal fixation was found to be effective in the treatment of ankle arthritis. The levels of sport and physical activity were satisfactory in both groups, but the outcomes after fixation with the Ilizarov apparatus were better than after internal stabilization.

Key words

sport, physical activity, internal fixation, ankle arthrodesis, Ilizarov fixation

References (28)

  1. Chahal J, Stephen DJ, Bulmer B, Daniels T, Kreder HJ. Factors associated with outcome after subtalar arthrodesis. J Orthop Trauma. 2006;20(8):555–561.
  2. Dalat F, Trouillet F, Fessy MH, Bourdin M, Besse JL. Comparison of quality of life following total ankle arthroplasty and ankle arthrodesis: Retrospective study of 54 cases. Orthop Traumatol Surg Res. 2014;100(7):761–766.
  3. Morasiewicz P, Konieczny G, Pawik Ł, Dragan S. Sport and physical activity in patients after derotational corticotomies with the Ilizarov method. Acta Orthop Belg. 2015;81:90–99.
  4. MacMahon A, Kim P, Levine D, et al. Return to sports and physical activities after primary partial arthrodesis for Lisfranc injuries in young patients. Foot Ankle Int. 2016;37(4):355–362.
  5. Schuh R, Hofstaetter J, Krismer M, Bevoni R, Windhager R, Trnka HJ. Total ankle arthroplasty versus ankle arthrodesis: Comparison of sports, recreational activities and functional outcome. Int Orthop. 2012;36(6):1207–1214.
  6. Fragomen AT, Borst E, Schachter L, Lyman S, Rozbruch RS. Complex ankle arthrodesis using the Ilizarov method yields high rate of fusion. Clin Orthop Relat Res. 2012;470(10):2864–2873.
  7. Rabinovich RV, Haleem AM, Rozbruch SR. Complex ankle arthrodesis: Review of the literature. World J Orthop. 2015;6(8):602–613.
  8. Siebachmeyer M, Boddu K, Bilal A, et al. Outcome of one-stage correction of deformities of the ankle and hindfoot and fusion in Charcot neuroarthropathy using a retrograde intramedullary hindfoot arthrodesis nail. Bone Joint J. 2015;97-B(1):76–82.
  9. Perlman MH, Thordarson DB. Ankle fusion in a high risk population: An assessment of nonunion risk factors. Foot Ankle Int. 1999;20(8): 491–496.
  10. Jang JJ, Schipper ON, Whyte N, Koh JL, Toolan BC. Comparison of perioperative complications and hospitalization outcomes after ankle arthrodesis versus total ankle arthroplasty from 2002 to 2011. Foot Ankle Int. 2015;36(4):360–368.
  11. Tellisi N, Fragomen AT, Ilizarov S, Rozbruch SR. Limb salvage reconstruction of the ankle with fusion and simultaneous tibial lengthening using the Ilizarov/Taylor spatial frame. HSS J. 2008;4(1):32–42.
  12. Katsenis D, Bhave A, Paley D, Herzenberg JE. Treatment of malunion and nonunion at the site of an ankle fusion with the Ilizarov apparatus. J Bone Joint Surg Am. 2005;87(2):302–329.
  13. Onodera T, Majima T, Kasahara Y, et al. Outcome of transfibular ankle arthrodesis with Ilizarov apparatus. Foot Ankle Int. 2012;33(11):964–968.
  14. Salem KH, Kinzl L, Schmelz A. Ankle arthrodesis using Ilizarov ring fixators: A review of 22 cases. Foot Ankle Int. 2006;27(10):764–770.
  15. Ling JS, Smyth NA, Fraser EJ, et al. Investigating the relationship between ankle arthrodesis and adjacent-joint arthritis in the hindfoot: A systematic review. J Bone Joint Surg Am. 2015;97(6):513–520.
  16. Houdek MT, Wilke BK, Ryssman DB, Turner NS. Radiographic and functional outcomes following bilateral ankle fusions. Foot Ankle Int. 2014;35(12):1250–1254.
  17. Strasser NL, Turner NS. Functional outcomes after ankle arthrodesis in elderly patients. Foot Ankle Int. 2012;33(9):699–703.
  18. Hendrickx RP, Stufkens SA, de Bruijn EE, Sierevelt IN, van Dijk CN, Kerkhoffs GM. Medium- to long-term outcome of ankle arthrodesis. Foot Ankle Int. 2011;32(10):940–947.
  19. Slater GL, Sayres SC, O’Malley MJ. Anterior ankle arthrodesis. World J Orthop. 2014;5(1):1–5.
  20. Martin RL, Irrgang JJ, Burdett RG, Conti SF, Van Swearingen JM. Evidence of validity for the Foot and Ankle Ability Measure (FAAM). Foot Ankle Int. 2005;26(11):968–983.
  21. Bednarz P, Beals T, Manila A. Subtalar distraction bone blok fusion: An assessment of outcome. Foot Ankle Int. 1997;18(12):785–791.
  22. Morasiewicz P, Dejnek M, Urbański W, Dragan SŁ, Kulej M, Dragan SF. Radiological evaluation of ankle arthrodesis with Ilizarov fixation compared to internal fixation. Injury. 2017;48(7):1678–1683.
  23. Grimby G. Physical activity: Muscle training in the elderly. Acta Medica Scand Suppl. 1986 ;711:233–237.
  24. Saleh K, Mulhall K, Bershadsky B, et al. Development and validation of a lower-extremity activity scale: Use for patients treated with revision total knee arthroplasty. J Bone Joint Surg Am. 2005;87(9): 1985–1994.
  25. Amstutz H, Thomas B, Jinnah R, Kim W, Grogan T, Yale C. Treatment of primary osteoarthritis of the hip: A comparison of total join and surface replacement arthroplasty. J Bone Joint Surg Am. 1984;66(2):228–241.
  26. Zahiri C, Schmalzried T, Szuszczewicz E, Amstutz HC. Assessing activity in joint replacement patients. J Arthroplasty. 1998;13(8):890–895.
  27. McKee M, Yoo D, Schemitsch E. Health status after Ilizarov reconstruction of post-traumatic lower-limb deformity. J Bone Joint Surg Br. 1998;80(2):360–364.
  28. Braito M, Dammerer D, Kaufmann G, et al. Are our expectations bigger than the results we achieve? A comparative study analyzing potential advantages of ankle arthroplasty over arthrodesis. Int Orthop. 2014;38(8):1647–1653.