Study Shows Challenging Outcomes for Ankle Arthritis Patients Undergoing Standard Surgical Treatment for Ankle Sprain and Cavus Foot

ROSEMONT, Ill.,  Nov. 16, 2010 /PRNewswire-USNewswire/ --  A recent study published in the November issue of Foot & Ankle International (FAI), the official scientific journal of the American Orthopaedic Foot & Ankle Society (AOFAS) shows patients with moderate to severe ankle arthritis who were treated surgically for ankle instability secondary to multiple sprains as well as a high-arched (cavus) foot had poorer outcomes over the long-term than patients with no or minimal ankle arthritis.  The study suggests orthopaedic surgeons take a cautious, realistic approach when recommending surgical treatment options for this set of patients.  

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Ankle sprains are a common orthopaedic injury but when multiple sprains over time lead to instability, ankle arthritis may occur if left untreated.  This condition is especially prevalent in patients with cavus foot deformity (present in 24% of the population).

Todd Irwin, MD, lead author of the study and an active AOFAS member says, "There are excellent treatment options for patients who have both chronic ankle instability and high arched feet.  However, if this combination has led to significant ankle pain and arthritis as seen on x-rays, there should be a discussion with the treating physician regarding the most appropriate surgical option.  Our study shows that with longer term follow-up compared to previous studies, if the arthritis has reached a certain level of significance it is unlikely to improve and very likely to worsen despite surgery to stabilize the ankle and correct the foot deformity."

This five year study looked at the effect varying levels of ankle arthritis had on the clinical outcomes of 22 patients who had undergone lateral ankle ligament reconstruction and corrective osteotomy for cavovarus deformity.  Two patient groups were established, those with no to minimal pre-operative ankle arthritis (Group 1) and those with moderate to severe pre-operative ankle arthritis (Group 2).  At a five-year follow-up, the clinical results revealed significant ankle arthritis progression in the majority of patients in Group 2 with no significant progression among patients in Group 1.  Post operative pain levels were lower in Group 1 and overall satisfaction rate was higher in Group 1 than in participants in Group 2.  The findings are noteworthy for patients with the combination of high arched feet, ankle instability and ankle pain, and their orthopaedic surgeons who must determine if a more extensive surgical procedure to treat the ankle arthritis, such as ankle fusion or ankle replacement, might be considered as a first alternative.

To find an orthopaedic foot and ankle surgeon in your area, go to www.aofas.org and click on Find an Orthopaedic Foot and Ankle MD/DO.

Photo and Bio of Todd Irwin, MD:  http://www.aofas.org/userfiles/file/newscenter/bio_tirwin.pdf

Orthopaedic Distinction:  http://www.aofas.org/Scripts/4Disapi.dll/4DCGI/cms/review.html?Action=CMS_Document&DocID=7

AOFAS News Center:  http://www.aofas.org/Scripts/4Disapi.dll/4DCGI/cms/review.html?Action=CMS_Document&DocID=127

About AOFAS

The AOFAS promotes quality, ethical and cost-effective patient care through education, research and training of orthopaedic surgeons and other health care providers. It creates public awareness for the prevention and treatment of foot and ankle disorders, provides leadership, and serves as a resource for government, industry and the national and international health care community.

About Orthopaedic Foot and Ankle Surgeons

Orthopaedic foot and ankle surgeons are medical doctors (MD and DO) who specialize in the diagnosis, care, and treatment of patients with disorders of the musculoskeletal system of the foot and ankle. This includes the bones, joints, ligaments, muscles tendons, nerves, and skin. Orthopaedic foot and ankle surgeons use medical, physical, and rehabilitative methods as well as surgery to treat patients of all ages. They perform reconstructive procedures, treat sports injuries, and manage and treat trauma of the foot and ankle.

Orthopaedic foot and ankle surgeons work with physicians of many other specialties, including internal medicine, pediatrics, vascular surgery, endocrinology, radiology, anesthesiology, and others. Medical school curriculum and post-graduate training provides the solid clinical background necessary to recognize medical problems, admit patients to a hospital when necessary, and contribute significantly to the coordination of care appropriate for each patient.

SOURCE American Orthopaedic Foot & Ankle Society