Role of Prosthetic Alignment and Heterotopic Calcifications in Total Ankle Arthroplasty
Abstract
Introduction: The main objective of this work is to evaluate the relationship between the formation of heterotopic calcifications and the alignment parameters of the prosthesis. Materials and Methods: The population under study comprised 31 patients. The radiographic alignment variables evaluated were alpha and beta angles, the talar center of rotation, and the percentage of posterior coverage of the tibia in the immediate postoperative period and after 2 years. The clinical evaluation variables were: VAS, AOFAS, and the SF-36 questionnaire to evaluate quality of life at the end of follow-up. Results: The most frequent etiology of osteoarthritis was post-traumatic (67.7%). In the immediate postoperative period, the mean alpha angle was 88.7° (range 82-92.6°; SD± 2.61); the mean beta angle was 84.46° (range 78°, 62-91.40°; SD ±3.59). The alignment of the tibial component in the anteroposterior plane was neutral in 25 patients (80.6%), valgus in 6 (19.4%), and varus in none. At 2 years of follow-up, 96% presented heterotopic calcifications. An improvement was verified both in the AOFAS (pre/post 31.90/80.94) and in the VAS scales (pre/post: 8.7/1.97) (p<0.05). Conclusions: No relationship was found between heterotopic calcification and worse functional outcomes or pain, except for quality-of-life parameters (SF-36) such as physical condition, emotional limitation, and general health perception, which worsened as the degree of calcifications around the prosthesis increased.Downloads
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