Comparison of Tibial and Talar Bone Density in Patients Undergoing Total Ankle Replacement vs Non-Ankle Arthritis Matched Controls.


Journal

Foot & ankle international
ISSN: 1944-7876
Titre abrégé: Foot Ankle Int
Pays: United States
ID NLM: 9433869

Informations de publication

Date de publication:
Dec 2019
Historique:
pubmed: 20 8 2019
medline: 2 6 2020
entrez: 20 8 2019
Statut: ppublish

Résumé

Bone quality in the distal tibia and talus is an important factor contributing to initial component stability in total ankle replacement (TAR). However, the effect of ankle arthritis on bone density in the tibia and talus remains unclear. The objective of this study was to compare bone density of tibia and talus in arthritic and nonarthritic ankles as a function of distance from ankle joint. We retrospectively reviewed 93 end-stage ankle arthritis patients who had preoperative nonweightbearing ankle computed tomography (CT) and identified a cohort of 83 nonarthritic ankle patients as a demographic-matched control group. A region of interest tool was used to calculate Hounsfield unit (HU) values in the cancellous region of the tibia and talus. Measurements were obtained on axial cut CTs from 6 to 12 mm above the tibial plafond, and 1 to 4 mm below the talar dome. HU measurements between groups and the decrease of HU at the relative level in each group were compared. Arthritic ankles demonstrated significantly greater mean bone density than nonarthritic ankles at between 6 and 10 mm above the joint in the tibia ( Ankle arthritis patients demonstrated greater or equal bone density in both the tibia and talus compared to demographic-matched controls. In both groups, bone density decreased with increasing distance away from the articular surface. In TAR, tibial bone resection between 6 and 8 mm may provide improved initial implant stability. Level III, comparative study.

Sections du résumé

BACKGROUND BACKGROUND
Bone quality in the distal tibia and talus is an important factor contributing to initial component stability in total ankle replacement (TAR). However, the effect of ankle arthritis on bone density in the tibia and talus remains unclear. The objective of this study was to compare bone density of tibia and talus in arthritic and nonarthritic ankles as a function of distance from ankle joint.
METHODS METHODS
We retrospectively reviewed 93 end-stage ankle arthritis patients who had preoperative nonweightbearing ankle computed tomography (CT) and identified a cohort of 83 nonarthritic ankle patients as a demographic-matched control group. A region of interest tool was used to calculate Hounsfield unit (HU) values in the cancellous region of the tibia and talus. Measurements were obtained on axial cut CTs from 6 to 12 mm above the tibial plafond, and 1 to 4 mm below the talar dome. HU measurements between groups and the decrease of HU at the relative level in each group were compared.
RESULTS RESULTS
Arthritic ankles demonstrated significantly greater mean bone density than nonarthritic ankles at between 6 and 10 mm above the joint in the tibia (
CONCLUSION CONCLUSIONS
Ankle arthritis patients demonstrated greater or equal bone density in both the tibia and talus compared to demographic-matched controls. In both groups, bone density decreased with increasing distance away from the articular surface. In TAR, tibial bone resection between 6 and 8 mm may provide improved initial implant stability.
LEVEL OF EVIDENCE METHODS
Level III, comparative study.

Identifiants

pubmed: 31423826
doi: 10.1177/1071100719868496
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1408-1415

Auteurs

Thos Harnroongroj (T)

Foot and Ankle Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Department of Orthopaedics and Rehabilitation, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Lauren G Volpert (LG)

Foot and Ankle Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Scott J Ellis (SJ)

Foot and Ankle Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Carolyn M Sofka (CM)

Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA.

Jonathan T Deland (JT)

Foot and Ankle Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.

Constantine A Demetracopoulos (CA)

Foot and Ankle Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.

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