Joint sparing treatments in early ankle osteoarthritis: current procedures and future perspectives

Castagnini, Francesco; Pellegrini, Camilla; Perazzo, Luca; Vannini, Francesca; Buda, Roberto

doi:10.1186/s40634-016-0038-4

Journal of Experimental Orthopaedics

Table 1 Features and results of the selected papers about arthroscopic debridement, arthrodiastasis and osteotomy in AOA

From: Joint sparing treatments in early ankle osteoarthritis: current procedures and future perspectives

Authors	Year of publication	Type of study	Number of patients	Inclusion criteria	Treatment	Follow-up (months)	Clinical results	Radiological results	Notes
Arthroscopic debridement
Tol et al	2001	Prospective case series	57	Anterio bony impingement and moderate AOA	Arthroscopic debridement	78	Excellent or good (VAS and Tegner)	65 % successful	AOA reduces the success rate
Parma et al	2014	Retrospective case series	80	Anterio bony impingement and moderate AOA	Arthroscopic debridement	105	Aofas score 70.7 pt at final follow-up	NA	Chondral lesions, age and cavus foot negatively affect the outcome
Choi et al	2013	Retrospective case series	63	Mild and moderate AOA	Arthroscopic debridement	71	Aofas score 76.2 pt at final follow-up	NA	High BMI and chondral lesions reduce the success rate
Hassouna et al	2007	Prospective case series	80	Anterio bony impingement and moderate AOA	Arthroscopic debridement	60	28 % requiring major surgery at 5 years	NA	AOA reduces the success rate
Arthrodiastasis
Ploegmaker et al	2005	Retrospective case series	25	Severe AOA	Fixed joint distraction	84	73 % clinical benefit at 7 years	NA	Distraction has long term benefit
Marijnissen et al	2002	Open prospective study	57	Severe AOA	Fixed joint distraction	34	Good pain control, more mobility	Joint space width increased 10 %	Improvement increased over the time
Marijnissen et al	2002	Randomized controlled trial	17	Severe AOA	Joint distraction vs debridement	12	Good pain control, more mobility	Less subchondral sclerosis, more joint space	Better clinical and radiological results for arthrodiastasis
Tellisi et al	2009	Retrospective case series	25	Severe AOA	Joint distraction	30	Aofas score at the final follow-up: 74	NA	91 % improved pain
Nguyen et al	2015	Retrospective case series	36	Severe AOA	Fixed joint distraction	60	45 % requiring arthrodesis or replacement	Progression of AOA	Outcome decreased over the time
Marijnissen et al	2014	Retrospective case series	111	Severe AOA	Fixed or hinged joint distraction	144	50 % of failures	NA	Outcome decreased over the time
Osteotomy
Knupp et al	2011	Prospective case series	94	Asimmetric AOA	Supramalleolar osteotomy	43	Good clinical improvement	AOA improved	10 patients failed
Colin et al	2014	Retrospective case series	83	Asimmetric AOA	Supramalleolar osteotomy	42	Aofas score 73 pt for varus and 80 for valgus	Improved	Sidewalk sign to assess the correct indication
Kim et al	2014	Retrospective case series	31	Asimmetric (varus) AOA	Supramalleolar osteotomy and microfractures	27	Aofas score 83.1 pt at final follow-up	42 % AOA advancement	Microfractures may improve the results

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