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Mark Glazebrook - One of the best experts on this subject based on the ideXlab platform.

  • Prospective Cohort Study on the Employment Status of Working Age Patients After Recovery From Ankle Arthritis Surgery.
    Foot & ankle international, 2018
    Co-Authors: Oliver J. Gagne, Mark Glazebrook, Murray J. Penner, Kevin Wing, Timothy R. Daniels, Andrea Veljkovic, Alastair Younger
    Abstract:

    Background:People who are affected by end-stage Ankle Arthritis are as disabled as those suffering from Arthritis in other main articulations of the lower extremity. Once these patients become unable to perform their job duties, they leave the workforce and require financial aid from government agencies, which represents a considerable economic burden. Regardless of whether arthrodesis or arthroplasty is performed, we hypothesized that patients younger than 55 years at the time of surgery should be able to return to work within 2 years and require less social assistance.Methods:Patients from 2002 to 2014 included in the nationwide prospective Ankle Reconstruction Database treated for end-stage Ankle Arthritis with a total Ankle replacement or an Ankle arthrodesis and younger than 55 years at the time of surgery were included. This study used a standard preoperative survey (AAOS, SF-36) along with the same survey filled by patients in intervals up to 2 years postoperatively. Their employment status was det...

  • Association of Ankle Arthritis Score With Need for Revision Surgery.
    Foot & ankle international, 2017
    Co-Authors: Stephen Croft, Mark Glazebrook, Murray J. Penner, Kevin Wing, Timothy R. Daniels, Alastair Younger, Peter Dryden, Jason M. Sutherland
    Abstract:

    Background:The Ankle Arthritis Score (AAS) is a new patient-reported outcome derived from the Ankle OsteoArthritis Scale (AOS). This study analyzed longitudinally collected data from a cohort of pa...

  • The postoperative COFAS end-stage Ankle Arthritis classification system: interobserver and intraobserver reliability
    Foot & ankle specialist, 2012
    Co-Authors: Fabian Krause, Mark Glazebrook, Matthew Di Silvestro, Murray J. Penner, Kevin Wing, Timothy R. Daniels, Johnny T.c. Lau, Alastair Younger
    Abstract:

    End-stage Ankle Arthritis is operatively treated with numerous designs of total Ankle replacement and different techniques for Ankle fusion. For superior comparison of these procedures, outcome research requires a classification system to stratify patients appropriately. A postoperative 4-type classification system was designed by 6 fellowship-trained foot and Ankle surgeons. Four surgeons reviewed blinded patient profiles and radiographs on 2 occasions to determine the interobserver and intraobserver reliability of the classification. Excellent interobserver reliability (κ = .89) and intraobserver reproducibility (κ = .87) were demonstrated for the postoperative classification system. In conclusion, the postoperative Canadian Orthopaedic Foot and Ankle Society (COFAS) end-stage Ankle Arthritis classification system appears to be a valid tool to evaluate the outcome of patients operated for end-stage Ankle Arthritis.

  • 79. PREFERENCE-BASED QUALITY OF LIFE IN END-STAGE Ankle Arthritis, TOTAL Ankle ARTHROPLASTY, AND Ankle ARTHODESIS
    2011
    Co-Authors: Gerard P Slobogean, Murray J. Penner, Alastair S. E. Younger, Carlo A. Marra, Kevin J. Wing, Mark Glazebrook
    Abstract:

    Purpose: To describe the pre- and one-year post-operative preference-based, health related quality of life (health state values) among a cohort of subjects with end-stage Ankle Arthritis treated with total Ankle arthroplasty or Ankle arthrodesis. This short-term study is not intended to compare the efficacy of arthoplasty and arthrodesis.Method: The Short-Form 36 (SF-36) was prospectively completed by subjects enrolled in the Canadian Orthopaedic Foot and Ankle Society Multicentered Ankle Arthritis Outcome Study between 2003 and 2005. Preference-based quality of life was assessed pre-operatively and at one-year post-procedure using health state values (HSVs) derived from the SF-36 transformation described by Brazier (SF-6D). The SF-6D scores are anchored at 1.0 (full health) and at 0 (death). Basic patient demographic and treatment information was also collected. The decision to perform arthroplasty or arthrodesis was made by the attending surgeon.Results: Two hundred four of the 214 eligible subjects had...

  • End-stage Ankle Arthritis: magnitude of the problem and solutions.
    Instructional course lectures, 2010
    Co-Authors: Mark Glazebrook
    Abstract:

    Patients with end-stage Ankle Arthritis have a significantly compromised health-related quality of life. Nonsurgical treatments for end-stage Ankle Arthritis should be considered prior to surgery. Currently, the most accepted surgical treatment is Ankle arthrodesis. The shortcomings of Ankle arthrodesis, such as increased rates of ipsilateral periarticular Arthritis and the possible long-term need for amputation, have cast doubt on the success of this treatment for end-stage Ankle Arthritis. Newer second and third generation total Ankle arthroplasty prostheses have shown positive short- and medium-term results. An examination of the available literature provides good evidence to support Ankle arthrodesis and total Ankle arthroplasty for treating patients with end-stage Ankle Arthritis. Other treatment options, including Ankle osteotomies, Ankle osteochondral allograft transplantation, and distraction arthroplasty, require further study by surgeons with advanced training in these procedures.

Alastair Younger - One of the best experts on this subject based on the ideXlab platform.

Constantine A Demetracopoulos - One of the best experts on this subject based on the ideXlab platform.

  • Comparison of Tibial and Talar Bone Density in Patients Undergoing Total Ankle Replacement vs Non–Ankle Arthritis Matched Controls:
    Foot & ankle international, 2019
    Co-Authors: Thos Harnroongroj, Scott J. Ellis, Jonathan T Deland, Lauren Volpert, Carolyn M. Sofka, Constantine A Demetracopoulos
    Abstract:

    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 ...

  • management of end stage Ankle Arthritis cost utility analysis using direct and indirect costs
    Journal of Bone and Joint Surgery American Volume, 2015
    Co-Authors: Benedict U Nwachukwu, Alexander S Mclawhorn, Matthew S Simon, Constantine A Demetracopoulos, Kamran S. Hamid, Jonathan T Deland, Scott J. Ellis
    Abstract:

    Background: Total Ankle replacement and Ankle fusion are costly but clinically effective treatments for Ankle Arthritis. Prior cost-effectiveness analyses for the management of Ankle Arthritis have been limited by a lack of consideration of indirect costs and nonoperative management. The purpose of this study was to compare the cost-effectiveness of operative and nonoperative treatments for Ankle Arthritis with inclusion of direct and indirect costs in the analysis. Methods: Markov model analysis was conducted from a health-systems perspective with use of direct costs and from a societal perspective with use of direct and indirect costs. Costs were derived from the 2012 Nationwide Inpatient Sample (NIS) and expressed in 2013 U.S. dollars; effectiveness was expressed in quality-adjusted life years (QALYs). Model transition probabilities were derived from the available literature. The principal outcome measure was the incremental cost-effectiveness ratio (ICER). Results: In the direct-cost analysis for the base case, total Ankle replacement was associated with an ICER of $14,500/QALY compared with nonoperative management. When indirect costs were included, total Ankle replacement was both more effective and resulted in $5900 and $800 in lifetime cost savings compared with the lifetime costs following nonoperative management and Ankle fusion, respectively. At a $100,000/QALY threshold, surgical management of Ankle Arthritis was preferred for patients younger than ninety-six years and total Ankle replacement was increasingly more cost-effective in younger patients. Total Ankle replacement, Ankle fusion, and nonoperative management were the preferred strategy in 83%, 12%, and 5% of the analyses, respectively; however, our model was sensitive to patient age, the direct costs of total Ankle replacement, the failure rate of total Ankle replacement, and the probability of Arthritis after Ankle fusion. Conclusions: Compared with nonoperative treatment for the management of end-stage Ankle Arthritis, total Ankle replacement is preferred over Ankle fusion; total Ankle replacement is cost-saving when indirect costs are considered and demonstrates increasing cost-effectiveness in younger patients. As indications for and utilization of total Ankle replacement increase, continued research is needed to define appropriate subgroups of patients who would likely derive the greatest clinical benefit from that procedure. Level of Evidence: Economic and decision analysis Level II. See Instructions for Authors for a complete description of levels of evidence.

  • Total Ankle arthroplasty in end-stage Ankle Arthritis
    Current Reviews in Musculoskeletal Medicine, 2013
    Co-Authors: Constantine A Demetracopoulos, James P. Halloran, Paul Maloof, Samuel B. Adams, Selene G. Parekh
    Abstract:

    Recent advancements in Ankle prosthesis design, combined with improved surgical techniques for correction of coronal plane deformity and ligamentous balancing, have led to a resurgence of interest in total Ankle arthroplasty for the treatment of end-stage Ankle Arthritis. Although Ankle arthrodesis has long been considered the gold standard treatment for Ankle Arthritis, recent studies have shown that patients who undergo total Ankle replacement have equivalent pain relief and improved function, when compared with patients with an Ankle fusion. The purpose of this review is to summarize the indications, advantages, disadvantages, and clinical outcomes of some of the more commonly used modern prostheses for total Ankle arthroplasty.

Murray J. Penner - One of the best experts on this subject based on the ideXlab platform.

Alexej Barg - One of the best experts on this subject based on the ideXlab platform.