Saltzman, J Bone Joint Surg Am 2012 - Motion versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis - Article Summary

Motion versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

Saltzman, Amendola, et al.·J Bone Joint Surg Am·2012·95 citations·RCT

Background

Initial reports have shown the efficacy of fixed distraction for the treatment of ankle osteoarthritis. We hypothesized that allowing ankle motion during distraction would result in significant improvements in outcomes compared with distraction without ankle motion.

Methods

We conducted a prospective randomized controlled trial comparing the outcomes for patients with advanced ankle osteoarthritis who were managed with anterior osteophyte removal and either (1) fixed ankle distraction or (2) ankle distraction permitting joint motion.
36 patients were randomized to treatment with either fixed distraction or distraction with motion.
The patients were followed for 24 months after frame removal.
The Ankle Osteoarthritis Scale (AOS) was the main outcome variable.

Results

2 years after frame removal, subjects in both groups showed significant improvement compared with the status before treatment (p < 0.02 for both groups).
The motion-distraction group had significantly better AOS scores than the fixed-distraction group at 26, 52, and 104 weeks after frame removal (p < 0.01 at each time point).
At 104 weeks, the motion-distraction group had an overall mean improvement of 56.6% in the AOS score, whereas the fixed-distraction group had a mean improvement of 22.9% (p < 0.01).

Conclusions

Distraction improved the patient-reported outcomes of treatment of ankle osteoarthritis. Adding ankle motion to distraction showed an early and sustained beneficial effect on outcome.

Supplemental

Motion versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

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Motion versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

Saltzman, Amendola, et al.·J Bone Joint Surg Am·2012·95 citations·RCT

Free Full Text·DOI·PubMed

Background

Methods

We conducted a prospective randomized controlled trial comparing the outcomes for patients with advanced ankle osteoarthritis who were managed with anterior osteophyte removal and either (1) fixed ankle distraction or (2) ankle distraction permitting joint motion.
36 patients were randomized to treatment with either fixed distraction or distraction with motion.
The patients were followed for 24 months after frame removal.
The Ankle Osteoarthritis Scale (AOS) was the main outcome variable.

Results

2 years after frame removal, subjects in both groups showed significant improvement compared with the status before treatment (p < 0.02 for both groups).
The motion-distraction group had significantly better AOS scores than the fixed-distraction group at 26, 52, and 104 weeks after frame removal (p < 0.01 at each time point).
At 104 weeks, the motion-distraction group had an overall mean improvement of 56.6% in the AOS score, whereas the fixed-distraction group had a mean improvement of 22.9% (p < 0.01).

Conclusions

Distraction improved the patient-reported outcomes of treatment of ankle osteoarthritis. Adding ankle motion to distraction showed an early and sustained beneficial effect on outcome.

Background

Methods

We conducted a prospective randomized controlled trial comparing the outcomes for patients with advanced ankle osteoarthritis who were managed with anterior osteophyte removal and either (1) fixed ankle distraction or (2) ankle distraction permitting joint motion.
36 patients were randomized to treatment with either fixed distraction or distraction with motion.
The patients were followed for 24 months after frame removal.
The Ankle Osteoarthritis Scale (AOS) was the main outcome variable.

Results

2 years after frame removal, subjects in both groups showed significant improvement compared with the status before treatment (p < 0.02 for both groups).
The motion-distraction group had significantly better AOS scores than the fixed-distraction group at 26, 52, and 104 weeks after frame removal (p < 0.01 at each time point).
At 104 weeks, the motion-distraction group had an overall mean improvement of 56.6% in the AOS score, whereas the fixed-distraction group had a mean improvement of 22.9% (p < 0.01).

Conclusions

Distraction improved the patient-reported outcomes of treatment of ankle osteoarthritis. Adding ankle motion to distraction showed an early and sustained beneficial effect on outcome.

Background

Methods

We conducted a prospective randomized controlled trial comparing the outcomes for patients with advanced ankle osteoarthritis who were managed with anterior osteophyte removal and either (1) fixed ankle distraction or (2) ankle distraction permitting joint motion.
36 patients were randomized to treatment with either fixed distraction or distraction with motion.
The patients were followed for 24 months after frame removal.
The Ankle Osteoarthritis Scale (AOS) was the main outcome variable.

Results

2 years after frame removal, subjects in both groups showed significant improvement compared with the status before treatment (p < 0.02 for both groups).
The motion-distraction group had significantly better AOS scores than the fixed-distraction group at 26, 52, and 104 weeks after frame removal (p < 0.01 at each time point).
At 104 weeks, the motion-distraction group had an overall mean improvement of 56.6% in the AOS score, whereas the fixed-distraction group had a mean improvement of 22.9% (p < 0.01).

Conclusions

Distraction improved the patient-reported outcomes of treatment of ankle osteoarthritis. Adding ankle motion to distraction showed an early and sustained beneficial effect on outcome.