Too young for an ankle replacement? Does the age of a patient impact on outcome following total ankle replacement
R. Varrall, A. Singh, J. Ramaskandhan, M.S. Siddique
1Newcastle upon Tyne Hospitals NHS Foundation Trust, Department of Orthopaedics, Newcastle upon Tyne, United Kingdom
2Newcastle upon Tyne Hospitals NHS Trust, Orthopaedic Research, Newcastle upon Tyne, United Kingdom
Introduction: Total Ankle Replacement is proving to be a viable option for younger patients with Post Traumatic Osteoarthritis of the Ankle. The aim of our study was to study the clinical and patient reported outcomes between patients of < 60 and >60 years who underwent TAR.
Method: Patients who underwent a TAR between March 2006 and May 2009 were invited to take part in the hospital patient registry. They were divided into two groups based on Age (Group A-Age>60 and Group B-Age< 60). Patient demographics, co-morbidities, Clinical (AOFAS) outcomes, patient reported outcomes (FAOS, SF-36, patient satisfaction) and complications were collected from patients pre-operatively and at 1, 2 and 3 years follow up. Comparisons were made between groups for all outcome measures.
Results: There were 56 patients in Group A and 32 patients in Group B. There was no difference in Gender, side of operation and diagnosis reported between the 2 groups (P>0.05). Group A reported higher number of co-morbidities than Group B (1.54 vs. 1.00); p=0.032. There was no difference in AOFAS scores and FAOS scores for pain and function at all follow up times (p>0.05). Although Group B reported worse scores for FAOS stiffness pre-operatively (p=0.002) and at 1 year (p=0.029); there was no difference between scores at 2 and 3 years follow up. There was no difference in SF-36 scores and patient satisfaction and complications between groups. We expect to have the 4 year results processed by October this year.
Conclusion: We have found satisfactory outcomes following TAR, both clinical and patient reported, irrespective of age of patient. Although long-term survivorship results for TAR are unavailable, we feel that younger age may not be a contra-indication to TAR as it provides good quality of life and potentially allows continuation of work.
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