Article

Severe post-traumatic ankle arthritis poses a reconstructive challenge in active
patients. Whereas traditional surgical treatments, i.e. arthrodesis and
arthroplasty, provide good pain relief, arthrodesis is associated to functional
and psychological limitations, and arthroplasty is prone to failure in the active
patient. More recently the use of bipolar fresh osteochondral allografts
transplantation has been proposed as a promising alternative to the traditional
treatments. Preliminary short- and long-term clinical outcomes for this procedure
have been reported, but no functional evaluations have been performed to date.
The clinical and functional outcomes of a series of 10 patients who underwent
allograft transplantation at a mean follow-up of 14 months are reported. Clinical
evaluation was performed with the AOFAS score, functional assessment by
state-of-the-art gait analysis. The clinical score significantly improved from a
median of 54 (range 12-65) pre-op to 76.5 (range 61-86) post-op (p=0.002). No
significant changes were observed for the spatial-temporal parameters, but motion
at the hip and knee joints during early stance, and the range of motion of the
ankle joint in the frontal plane (control: 13.8 degrees +/-2.9 degrees ; pre-op:
10.4 degrees +/-3.1 degrees , post-op: 12.9 degrees +/-4.2 degrees ; p=0.02)
showed significant improvements. EMG signals revealed a good recovery in
activation of the biceps femoris. This study showed that osteochondral allograft
transplantation improves gait patterns. Although re-evaluation at longer
follow-ups is required, this technique may represent the right choice for
patients who want to delay the need for more invasive joint reconstruction
procedures.
CI - Copyright (c) 2013 Elsevier B.V. All rights reserved.

Langue : ANGLAIS