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MR Vol.13 No.2 indexに戻る
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MODERN RHEUMATOLOGY
Vol.13 No.2 |
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Indications of total ankle arthroplasty for rheumatoid
arthritis: evaluation at 5 years or more after the operation
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| Fumio Shinomiya1, Masahiko Okada1, Yoshiaki
Hamada1, Takuya Fujimura1, Daisuke Hamada |
| (1) Department of Orthopaedic Surgery and
Rheumatology, Tokushima Kensei (CO-OP) Hospital, 4-9-1 Shimosuketou,
Tokushima
770-0805, Japan |
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| Abstract |
| The postoperative results of total ankle arthroplasty
(TAA) were surveyed, and the indications of TAA for rheumatoid
arthritis
(RA) were examined. We have performed TAA in properly selected
patients with indication of ankle joint destruction due to RA.
The subjects were 18 RA patients (20 joints) who underwent TAA
between April 1988 and April 1996. Type-ND or type-TNK Bioceram
was used without cement for possible revision of TAA. No destruction
of large joints was found in 8 patients, and TAA was used as
part of multiple arthroplasty in 10 patients. After the operation,
decrease in or disappearance of joint pain was obtained, and
range of motion and improved ability to walk were secured. The
clinical results were superior to those obtained for 17 joints
of 17 patients who underwent ankle arthrodesis during the same
period. However, a radiolucent zone was observed an X-ray examination
in every case, after 8 years on average (range 5?12 years) after
operation. Under present conditions, ankle arthrodesis should
be used for younger patients. When no destruction of the hip
or knee joint is found and the patient is 65 years of age or
older, we believe TAA is indicated. In cases of multiple arthroplasty
or with bilateral ankle joint destruction, TAA appears to be
useful if patients are young, considering their better life expectancy
and quality of life. |
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