Foot & Ankle International - July 2016 - (Page 703)

642757 FAIXXX10.1177/1071100716642757Foot & Ankle InternationalJung et al research-article2016 Article Anterior Heterotopic Ossification at the Talar Neck After Total Ankle Arthroplasty Foot & Ankle International® 2016, Vol. 37(7) 703-708 © The Author(s) 2016 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1071100716642757 fai.sagepub.com Hong-Geun Jung, MD, PhD1, Sang-Hun Lee, MD1, Min-Ho Shin, MD1, Dong-Oh Lee, MD1, Joon-Sang Eom, MD1, and Jong-Soo Lee, MD1 Abstract Background: Recently, as total ankle arthroplasty (TAA) has been widely performed, its outcomes and complications have been reported. Heterotopic ossification (HO) after TAA has been reported in the posterior compartment of the ankle. We report on a series of HOs that developed in the anterior compartment of the ankle at the talar neck region after TAA. Methods: TAA was performed using the Hintegra and the Mobility in 54 ankles (Hintegra, 21 ankles; Mobility, 33 ankles) from 2004 to 2012. The outcome was assessed by visual analog scale (VAS), the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, patient satisfaction, and radiographic evaluation. The HO was confirmed on the lateral ankle view. HO in the anterior compartment of the ankle was classified based on a modification of the Brooker classification. Results: After TAA, 13 HOs developed in 12 of the 54 ankles. Six HOs developed in the anterior compartment, and 7 HOs developed in the posterior compartment. The majority of the anterior compartment HO (5/6) was observed in the Mobility group. There was no significant relationship between HO and the clinical outcomes (VAS score, P = .62; AOFAS score, P = .31; ankle range of motion, P = .31). Conclusions: Besides the posterior ankle, the anterior compartment of the ankle in the talar neck region was demonstrated to be another potential area for HO after TAA. The development of anterior HO was strongly related to the wide exposure of the cancellous bony surface at the talar neck and therefore occurred more often with the Mobility than with the Hintegra prosthesis. Level of Evidence: Level III, retrospective comparative case series. Keywords: total ankle arthroplasty, Hintegra, mobility, heterotopic ossification, anterior compartment Introduction Recently, total ankle arthroplasty (TAA) has become a common operative treatment option for end-stage ankle arthritis.12,21,24 As total ankle arthroplasty (TAA) has become widely performed, its outcomes and perioperative complications have been reported in the literature.4,5,16,17,23 Among various reported complications of TAA, heterotopic ossification (HO) after TAA has been described. To our knowledge, all cases of HO after TAA that have been reported in the literature have been found to occur in the posterior compartment of the ankle,2,16,17,20,23 except for 1 report of HO formation at the anterior margin of the distal tibia.16 In the current study, we report HO after TAA that developed at the talar neck in the anterior compartment of the ankle. We also introduce a new classification system for HO in the anterior ankle compartment. Additionally, the association of the clinical outcome of anterior HO with ankle range of motion (ROM) was investigated. Methods Total ankle arthroplasty (TAA) was performed in 54 ankles (52 patients) from September 2004 to July 2012 by a single surgeon (H.G.J.). The mean age at surgery was 64.5 years (range, 39-78). A total of 29 TAAs were undertaken in males, and 23 TAAs were performed in females; 2 females underwent bilateral TAA. The average patient body mass index (BMI) was 26.7 (range, 21.1-38.1). The operation was performed for posttraumatic arthritis in 36 ankles (66.7%), primary osteoarthritis in 14 ankles (25.9%), rheumatoid arthritis in 3 ankles (5.5%) and postinfectious sequelae in 1 ankle (1.9%). All patients received a cementless mobile-bearing total ankle system. The Hintegra (Newdeal, Lyon, France) was used for 21 ankles (20 patients), and the Mobility (DePuy, Leeds, United Kingdom) was used for 33 ankles (32 patients). Of the 54 ankles (52 patients) that were initially included in the study, 5 ankles were lost to follow-up, but none of them showed either anterior or posterior HO before loss to follow-up. The mean follow-up period was 30.6 months (range, 12-61). 1 Department of Orthopedic Surgery, Konkuk University School of Medicine, Seoul, Korea Corresponding Author: Sang-Hun Lee, MD, Department of Orthopedic Surgery, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea. Email: skyroost@naver.com http://www.sagepub.com/journalsPermissions.nav http://fai.sagepub.com

Table of Contents for the Digital Edition of Foot & Ankle International - July 2016

TOC/TOC/Verso
Editorial Board
Advertiser Index
Long Term Follow-up of a Randomized Controlled Trial Comparing Scarf to Chevron Osteotomy in Hallux Valgus Correction
Clinical Outcome and Fusion Rate following Simultaneous Subtalar Fusion and Total Ankle Arthoplasty
Anterior Heterotopic Ossification at the Talar Neck After Total Ankle Arthroplasty
Secondary Arthrodesis After Total Ankle Arthroplasty
Functional Outcomes Following First Metatarsophalangeal Arthrodesis
Increased Reduction Clamp Force Associated With Syndesmotic Overcompression
Pain Threshold Tests in Patients With Heel Pain Syndrome
Long-term Results of Chronic Achilles Tendon Ruptures With V-Y Tendon Plasty and Fascia Turndown
Peroneal Tendon Abnormalities on Routine Magnetic Resonance Imaging of the Foot and Ankle
Incisura Morphology as a Risk Factor for Syndesmotic Malreduction
Total Arthroplasty of the Metatarsophalangeal Joint of the Hallux
Ankle Power and Endurance Outcomes Following Isolated Gastrocnemius Recession for Achilles Tendinopathy
Survey of Patient Insurance Status on Access to Specialty Foot and Ankle Care Under the Affordable Care Act
Proximal Gastrocnemius Release in the Treatment of Mechanical Metatarsalgia
Gastrocnemius Proximal Release in the Treatment of Mechanical Metatarsalgia: A Prospective Study of 78 Cases.
Response to "Letter Regarding: Gastrocnemius Proximal Release in the Treatment of Mechanical Metatarsalgia"
The Internal Brace for Midsubstance Achilles Ruptures
The Evolution of Patient Safety
Education Calendar
Foot & Ankle International - July 2016

Foot & Ankle International - July 2016