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Alexander Y Shin - One of the best experts on this subject based on the ideXlab platform.
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wrist first carpometacarpal joint and thumb interphalangeal joint Arthrodesis in patients with brachial plexus injuries
Journal of Hand Surgery (European Volume), 2012Co-Authors: Jennifer L Giuffre, Michelle F Kircher, Allen T Bishop, Richard J Spinner, Alexander Y ShinAbstract:PURPOSE: Wrist Arthrodesis, first carpometacarpal joint Arthrodesis, and thumb interphalangeal joint Arthrodesis can be used in conjunction with other reconstructive measures to improve function and grasp in patients with complete brachial plexus injuries. This study evaluates wrist Arthrodesis, first carpometacarpal joint Arthrodesis, and thumb interphalangeal joint Arthrodesis as measured by fusion rate, complications, and clinical outcomes. METHODS: A retrospective chart review was performed for 24 skeletally mature patients with brachial plexus injuries treated with wrist Arthrodesis by a dorsal plating technique, first carpometacarpal joint Arthrodesis by staples, and thumb interphalangeal joint Arthrodesis by a tension band wiring technique. Nineteen patients were subjectively evaluated using preArthrodesis and postArthrodesis Disabilities of the Shoulder, Arm, and Hand scores, visual analog pain scores, and a visual analog scale assessing appearance, function, hygiene, ease of daily care, pain, and overall satisfaction. RESULTS: There was 100% union rate with 1 postArthrodesis complication. One patient required wrist fusion plate removal because of painful hardware. Subjective patient assessments showed a statistically significant (P < .001) improvement in Disabilities of the Shoulder, Arm, and Hand scores (from 51 to 28) and pain scores (from 5.3 to 3.2) before and after arthrodeses. The visual analog questionnaire results revealed improvements in appearance, function, daily cares, hygiene, pain, and satisfaction. CONCLUSIONS: Wrist Arthrodesis, first carpometacarpal joint Arthrodesis, and thumb interphalangeal joint Arthrodesis had high union rates with minimal complications. Patients benefited from the improved function of their upper extremities and were satisfied with the surgery. The use of wrist, first carpometacarpal joint, and thumb interphalangeal joint arthrodeses in combination should be considered one of the reconstructive possibilities for patients with complete or nearly complete brachial plexus injuries.
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long term outcomes of trapeziometacarpal Arthrodesis in the management of trapeziometacarpal arthritis
Journal of Hand Surgery (European Volume), 2009Co-Authors: Marco Rizzo, Steven L Moran, Alexander Y ShinAbstract:Purpose Reported outcomes of trapeziometacarpal (TM) Arthrodesis have been contradictory. The purpose of this paper is to review the long-term results of TM Arthrodesis for arthritis with respect to clinical outcomes, union, development of adjacent joint arthritis, and complications. Methods A retrospective review of TM arthrodeses performed between 1970 and 2003 was undertaken. Among a total of 241 arthrodeses performed, 126 thumbs in 114 patients (79 women, 35 men) treated for osteoarthritis were available for follow-up evaluation. Pre- and postoperative clinical and radiographic data were reviewed. The average age was 57 years (range 32–77). The dominant hand was involved in 76 cases. Supplemental bone graft was used in 90 thumbs. Preoperative appositional (key) pinch, oppositional (tip) pinch, and grip strengths were 3.0 kg, 2.7 kg, and 14 kg, respectively. The average pain score on a scale of 0–10 was 6.6 (range 4–10). The average follow-up was 11.2 years (range 3–28 years). Results There were 17 nonunions. No correlation existed between the incidence of nonunion and the use of supplemental bone graft. Nine of 17 thumbs had re-operation, including revision Arthrodesis (6) and interposition or suspensionplasty (3). The appositional pinch, oppositional pinch, and grip strengths improved to 5.9 kg, 5.4 kg, and 23 kg, respectively (p Conclusions For most patients TM Arthrodesis reduces pain, improves function and results in excellent patient satisfaction. Despite the development of metacarpophalangeal and scaphotrapeziotrapezoid joint arthritis, intervention for these joints was rarely warranted. Type of study/level of evidence Therapeutic IV.
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Treatment of isolated injuries of the lunotriquetral ligament: A COMPARISON OF Arthrodesis, LIGAMENT RECONSTRUCTION AND LIGAMENT REPAIR
The Journal of bone and joint surgery. British volume, 2001Co-Authors: Alexander Y Shin, L. P. Weinstein, Richard A. Berger, A. T. BishopAbstract:We studied 57 patients with isolated lunotriquetral injuries treated by Arthrodesis, direct ligament repair, or ligament reconstruction. The outcomes were compared by using written questionnaires, the Disabilities of the Arm, Shoulder and Hand (DASH) score, range of movement, strength, morbidity and rates of reoperation. Isolated lunotriquetral injury was confirmed by arthroscopy or arthrotomy. The mean age of the patients was 30.7 years (15.4 to 53.7) and the injuries were subacute or chronic in 98.2%. Eight patients underwent lunotriquetral reconstruction using a distally-based strip of the tendon of extensor carpi ulnaris, 27 had lunotriquetral repair and 22 had lunotriquetral Arthrodesis. The mean follow-up was 9.5 years (2 to 22). The probability of remaining free from complications at five years was 68.6% for reconstruction, 13.5% for repair, and less than 1% for Arthrodesis. Of the lunotriquetral arthrodeses, 40.9% developed nonunion and 22.7% developed ulnocarpal impaction. The probability of not requiring further surgery at five years was 68.6% for reconstruction, 23.3% for repair and 21.8% for Arthrodesis. The DASH scores for each group were not significantly different. Objective improvements in strength and movement, subjective indicators of pain relief and satisfaction were significantly higher in the lunotriquetral repair and reconstruction groups than in those undergoing Arthrodesis.
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FOUR-CORNER Arthrodesis
Journal of the American Society for Surgery of the Hand, 2001Co-Authors: Alexander Y ShinAbstract:Although nearly every combination of intercarpal arthrodeses has been described, excision of the scaphoid and fusion of the remaining carpal bones in neutral alignment was a unique concept when it was introduced nearly 20 years ago. This time-tested and established procedure that is commonly known as the 4-corner or 4-bone Arthrodesis is based on the principle that the radiolunate articulation is often spared from degenerative changes from conditions that result in rotatory subluxations of the scaphoid. The 4-corner Arthrodesis is a motion-sparing, limited Arthrodesis that reliably results in pain relief, improved grip strength, and overall high patient satisfaction with low associated nonunion and complication rates. Copyright © 2001 by the American Society for Surgery of the Hand
Alastair Younger - One of the best experts on this subject based on the ideXlab platform.
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intermediate term results of total ankle replacement and ankle Arthrodesis a cofas multicenter study
Journal of Bone and Joint Surgery American Volume, 2014Co-Authors: Timothy R. Daniels, Peter J Dryden, Hubert Wong, Kevin Wing, Alastair Younger, Murray J Penner, Mark GlazebrookAbstract:Background: Surgical treatments for end-stage ankle arthritis include total ankle replacement and ankle Arthrodesis. Although Arthrodesis is a reliable procedure, ankle replacement is often preferred by patients. This prospective study evaluated intermediate-term outcomes of ankle replacement and Arthrodesis in a large cohort at multiple centers, with variability in ankle arthritis type, prosthesis type, surgeon, and surgical technique. We hypothesized that patient-reported clinical outcomes would be similar for both procedures. Methods: Patients in the Canadian Orthopaedic Foot and Ankle Society (COFAS) Prospective Ankle Reconstruction Database were treated with total ankle replacement (involving Agility, STAR, Mobility, or HINTEGRA prostheses) or ankle Arthrodesis by six subspecialty-trained orthopaedic surgeons at four centers between 2001 and 2007. Data collection included demographics, comorbidities, and the Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) scores. The preoperative and latest follow-up scores for patients with at least four years of follow-up were analyzed. Sensitivity analyses excluded ankles that had undergone revision. A linear mixed-effects regression model compared scores between the groups, adjusting for age, sex, side, smoking status, body mass index, inflammatory arthritis diagnosis, baseline score, and surgeon. Results: Of the 388 ankles (281 in the ankle replacement group and 107 in the Arthrodesis group), 321 (83%; 232 ankle replacements and eighty-nine arthrodeses) were reviewed at a mean follow-up of 5.5 ± 1.2 years. Patients treated with Arthrodesis were younger, more likely to be diabetic, less likely to have inflammatory arthritis, and more likely to be smokers. Seven (7%) of the arthrodeses and forty-eight (17%) of the ankle replacements underwent revision. The major complications rate was 7% for Arthrodesis and 19% for ankle replacement. The AOS total, pain, and disability scores and SF-36 physical component summary score improved between the preoperative and final follow-up time points in both groups. The mean AOS total score improved from 53.4 points preoperatively to 33.6 points at the time of follow-up in the Arthrodesis group and from 51.9 to 26.4 points in the ankle replacement group. Differences in AOS and SF-36 scores between the Arthrodesis and ankle replacement groups at follow-up were minimal after adjustment for baseline characteristics and surgeon. Conclusions: Intermediate-term clinical outcomes of total ankle replacement and ankle Arthrodesis were comparable in a diverse cohort in which treatment was tailored to patient presentation; rates of reoperation and major complications were higher after ankle replacement. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Peer Review This article was reviewed by the Editor-in-Chief and one Deputy Editor, and it underwent blinded review by two or more outside experts. It was also reviewed by an expert in methodology and statistics. The Deputy Editor reviewed each revision of the article, and it underwent a final review by the Editor-in-Chief prior to publication. Final corrections and clarifications occurred during one or more exchanges between the author(s) and copyeditors.
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impact of complications in total ankle replacement and ankle Arthrodesis analyzed with a validated outcome measurement
Journal of Bone and Joint Surgery American Volume, 2011Co-Authors: Fabian Krause, Biraj Bora, Markus Windolf, Kevin Wing, Murray J Penner, Alastair YoungerAbstract:Background: Major modifications in the design and techniques of total ankle replacement have challenged the perception that ankle Arthrodesis is the treatment of choice for end-stage ankle arthritis. High complication and revision rates have been reported after both procedures. Methods: We performed radiographic evaluations at a mean of thirty-nine months following 114 total ankle replacements done with use of commonly used implants and at a mean of thirty-seven months following forty-seven ankle arthrodeses. The mean age was sixty-four years for the patients (fifty-one female and sixty-three male) who underwent total ankle replacement and fifty-nine years in the patients (fifteen female and thirty-two male) who underwent ankle Arthrodesis. The impact of complications was analyzed with use of the Ankle Osteoarthritis Scale (AOS), a validated outcome instrument. Results: Both groups had significant improvement in the mean AOS score (p < 0.001). There was no significant difference in the mean improvement between the two groups (p = 0.96). The complication rate was 54% following total ankle replacement and 26% following ankle Arthrodesis, which was a significant difference (p = 0.003). The impact of major complications on the AOS outcome score was significant in both the total ankle replacement group (p = 0.031) and the ankle Arthrodesis group (p = 0.02). Conclusions: At the time of follow-up, at a minimum of two years postoperatively, the outcomes of total ankle replacement and ankle Arthrodesis, with regard to pain relief and function, were comparable. While the rate of complications was significantly higher following total ankle replacement, the impact of complications on outcome was clinically relevant in both groups. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
Kevin Wing - One of the best experts on this subject based on the ideXlab platform.
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intermediate term results of total ankle replacement and ankle Arthrodesis a cofas multicenter study
Journal of Bone and Joint Surgery American Volume, 2014Co-Authors: Timothy R. Daniels, Peter J Dryden, Hubert Wong, Kevin Wing, Alastair Younger, Murray J Penner, Mark GlazebrookAbstract:Background: Surgical treatments for end-stage ankle arthritis include total ankle replacement and ankle Arthrodesis. Although Arthrodesis is a reliable procedure, ankle replacement is often preferred by patients. This prospective study evaluated intermediate-term outcomes of ankle replacement and Arthrodesis in a large cohort at multiple centers, with variability in ankle arthritis type, prosthesis type, surgeon, and surgical technique. We hypothesized that patient-reported clinical outcomes would be similar for both procedures. Methods: Patients in the Canadian Orthopaedic Foot and Ankle Society (COFAS) Prospective Ankle Reconstruction Database were treated with total ankle replacement (involving Agility, STAR, Mobility, or HINTEGRA prostheses) or ankle Arthrodesis by six subspecialty-trained orthopaedic surgeons at four centers between 2001 and 2007. Data collection included demographics, comorbidities, and the Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) scores. The preoperative and latest follow-up scores for patients with at least four years of follow-up were analyzed. Sensitivity analyses excluded ankles that had undergone revision. A linear mixed-effects regression model compared scores between the groups, adjusting for age, sex, side, smoking status, body mass index, inflammatory arthritis diagnosis, baseline score, and surgeon. Results: Of the 388 ankles (281 in the ankle replacement group and 107 in the Arthrodesis group), 321 (83%; 232 ankle replacements and eighty-nine arthrodeses) were reviewed at a mean follow-up of 5.5 ± 1.2 years. Patients treated with Arthrodesis were younger, more likely to be diabetic, less likely to have inflammatory arthritis, and more likely to be smokers. Seven (7%) of the arthrodeses and forty-eight (17%) of the ankle replacements underwent revision. The major complications rate was 7% for Arthrodesis and 19% for ankle replacement. The AOS total, pain, and disability scores and SF-36 physical component summary score improved between the preoperative and final follow-up time points in both groups. The mean AOS total score improved from 53.4 points preoperatively to 33.6 points at the time of follow-up in the Arthrodesis group and from 51.9 to 26.4 points in the ankle replacement group. Differences in AOS and SF-36 scores between the Arthrodesis and ankle replacement groups at follow-up were minimal after adjustment for baseline characteristics and surgeon. Conclusions: Intermediate-term clinical outcomes of total ankle replacement and ankle Arthrodesis were comparable in a diverse cohort in which treatment was tailored to patient presentation; rates of reoperation and major complications were higher after ankle replacement. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Peer Review This article was reviewed by the Editor-in-Chief and one Deputy Editor, and it underwent blinded review by two or more outside experts. It was also reviewed by an expert in methodology and statistics. The Deputy Editor reviewed each revision of the article, and it underwent a final review by the Editor-in-Chief prior to publication. Final corrections and clarifications occurred during one or more exchanges between the author(s) and copyeditors.
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impact of complications in total ankle replacement and ankle Arthrodesis analyzed with a validated outcome measurement
Journal of Bone and Joint Surgery American Volume, 2011Co-Authors: Fabian Krause, Biraj Bora, Markus Windolf, Kevin Wing, Murray J Penner, Alastair YoungerAbstract:Background: Major modifications in the design and techniques of total ankle replacement have challenged the perception that ankle Arthrodesis is the treatment of choice for end-stage ankle arthritis. High complication and revision rates have been reported after both procedures. Methods: We performed radiographic evaluations at a mean of thirty-nine months following 114 total ankle replacements done with use of commonly used implants and at a mean of thirty-seven months following forty-seven ankle arthrodeses. The mean age was sixty-four years for the patients (fifty-one female and sixty-three male) who underwent total ankle replacement and fifty-nine years in the patients (fifteen female and thirty-two male) who underwent ankle Arthrodesis. The impact of complications was analyzed with use of the Ankle Osteoarthritis Scale (AOS), a validated outcome instrument. Results: Both groups had significant improvement in the mean AOS score (p < 0.001). There was no significant difference in the mean improvement between the two groups (p = 0.96). The complication rate was 54% following total ankle replacement and 26% following ankle Arthrodesis, which was a significant difference (p = 0.003). The impact of major complications on the AOS outcome score was significant in both the total ankle replacement group (p = 0.031) and the ankle Arthrodesis group (p = 0.02). Conclusions: At the time of follow-up, at a minimum of two years postoperatively, the outcomes of total ankle replacement and ankle Arthrodesis, with regard to pain relief and function, were comparable. While the rate of complications was significantly higher following total ankle replacement, the impact of complications on outcome was clinically relevant in both groups. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
Murray J Penner - One of the best experts on this subject based on the ideXlab platform.
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intermediate term results of total ankle replacement and ankle Arthrodesis a cofas multicenter study
Journal of Bone and Joint Surgery American Volume, 2014Co-Authors: Timothy R. Daniels, Peter J Dryden, Hubert Wong, Kevin Wing, Alastair Younger, Murray J Penner, Mark GlazebrookAbstract:Background: Surgical treatments for end-stage ankle arthritis include total ankle replacement and ankle Arthrodesis. Although Arthrodesis is a reliable procedure, ankle replacement is often preferred by patients. This prospective study evaluated intermediate-term outcomes of ankle replacement and Arthrodesis in a large cohort at multiple centers, with variability in ankle arthritis type, prosthesis type, surgeon, and surgical technique. We hypothesized that patient-reported clinical outcomes would be similar for both procedures. Methods: Patients in the Canadian Orthopaedic Foot and Ankle Society (COFAS) Prospective Ankle Reconstruction Database were treated with total ankle replacement (involving Agility, STAR, Mobility, or HINTEGRA prostheses) or ankle Arthrodesis by six subspecialty-trained orthopaedic surgeons at four centers between 2001 and 2007. Data collection included demographics, comorbidities, and the Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) scores. The preoperative and latest follow-up scores for patients with at least four years of follow-up were analyzed. Sensitivity analyses excluded ankles that had undergone revision. A linear mixed-effects regression model compared scores between the groups, adjusting for age, sex, side, smoking status, body mass index, inflammatory arthritis diagnosis, baseline score, and surgeon. Results: Of the 388 ankles (281 in the ankle replacement group and 107 in the Arthrodesis group), 321 (83%; 232 ankle replacements and eighty-nine arthrodeses) were reviewed at a mean follow-up of 5.5 ± 1.2 years. Patients treated with Arthrodesis were younger, more likely to be diabetic, less likely to have inflammatory arthritis, and more likely to be smokers. Seven (7%) of the arthrodeses and forty-eight (17%) of the ankle replacements underwent revision. The major complications rate was 7% for Arthrodesis and 19% for ankle replacement. The AOS total, pain, and disability scores and SF-36 physical component summary score improved between the preoperative and final follow-up time points in both groups. The mean AOS total score improved from 53.4 points preoperatively to 33.6 points at the time of follow-up in the Arthrodesis group and from 51.9 to 26.4 points in the ankle replacement group. Differences in AOS and SF-36 scores between the Arthrodesis and ankle replacement groups at follow-up were minimal after adjustment for baseline characteristics and surgeon. Conclusions: Intermediate-term clinical outcomes of total ankle replacement and ankle Arthrodesis were comparable in a diverse cohort in which treatment was tailored to patient presentation; rates of reoperation and major complications were higher after ankle replacement. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Peer Review This article was reviewed by the Editor-in-Chief and one Deputy Editor, and it underwent blinded review by two or more outside experts. It was also reviewed by an expert in methodology and statistics. The Deputy Editor reviewed each revision of the article, and it underwent a final review by the Editor-in-Chief prior to publication. Final corrections and clarifications occurred during one or more exchanges between the author(s) and copyeditors.
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impact of complications in total ankle replacement and ankle Arthrodesis analyzed with a validated outcome measurement
Journal of Bone and Joint Surgery American Volume, 2011Co-Authors: Fabian Krause, Biraj Bora, Markus Windolf, Kevin Wing, Murray J Penner, Alastair YoungerAbstract:Background: Major modifications in the design and techniques of total ankle replacement have challenged the perception that ankle Arthrodesis is the treatment of choice for end-stage ankle arthritis. High complication and revision rates have been reported after both procedures. Methods: We performed radiographic evaluations at a mean of thirty-nine months following 114 total ankle replacements done with use of commonly used implants and at a mean of thirty-seven months following forty-seven ankle arthrodeses. The mean age was sixty-four years for the patients (fifty-one female and sixty-three male) who underwent total ankle replacement and fifty-nine years in the patients (fifteen female and thirty-two male) who underwent ankle Arthrodesis. The impact of complications was analyzed with use of the Ankle Osteoarthritis Scale (AOS), a validated outcome instrument. Results: Both groups had significant improvement in the mean AOS score (p < 0.001). There was no significant difference in the mean improvement between the two groups (p = 0.96). The complication rate was 54% following total ankle replacement and 26% following ankle Arthrodesis, which was a significant difference (p = 0.003). The impact of major complications on the AOS outcome score was significant in both the total ankle replacement group (p = 0.031) and the ankle Arthrodesis group (p = 0.02). Conclusions: At the time of follow-up, at a minimum of two years postoperatively, the outcomes of total ankle replacement and ankle Arthrodesis, with regard to pain relief and function, were comparable. While the rate of complications was significantly higher following total ankle replacement, the impact of complications on outcome was clinically relevant in both groups. Level of Evidence: Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
Mark Glazebrook - One of the best experts on this subject based on the ideXlab platform.
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association between patient factors and outcome of synthetic cartilage implant hemiarthroplasty vs first metatarsophalangeal joint Arthrodesis in advanced hallux rigidus
Foot & Ankle International, 2017Co-Authors: A Goldberg, Mark Glazebrook, Dishan Singh, Chris Blundell, Gwyneth De Vries, Ian L D Le, Dominic Nielsen, Elizabeth M Pedersen, Anthony Sakellariou, Matthew SolanAbstract:Background:We evaluated data from a clinical trial of first metatarsophalangeal joint (MTPJ1) implant hemiarthroplasty and Arthrodesis to determine the association between patient factors and clinical outcomes.Methods:Patients ≥18 years with hallux rigidus grade 2, 3, or 4 were treated with synthetic cartilage implant MTPJ1 hemiarthroplasty or Arthrodesis. Pain visual analog scale (VAS), Foot and Ankle Ability Measure (FAAM) sports and activities of daily living (ADL) scores, and Short Form-36 Physical Function (SF-36 PF) subscore were obtained preoperatively, and at 2, 6, 12, 24, 52, and 104 weeks postoperatively. Final outcome data, great toe active dorsiflexion motion, secondary procedures, radiographs, and safety parameters were evaluated for 129 implant hemiarthroplasties and 47 arthrodeses. The composite primary endpoint criteria for clinical success included VAS pain reduction ≥30%, maintenance/improvement in function, no radiographic complications, and no secondary surgical intervention at 24 mont...
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intermediate term results of total ankle replacement and ankle Arthrodesis a cofas multicenter study
Journal of Bone and Joint Surgery American Volume, 2014Co-Authors: Timothy R. Daniels, Peter J Dryden, Hubert Wong, Kevin Wing, Alastair Younger, Murray J Penner, Mark GlazebrookAbstract:Background: Surgical treatments for end-stage ankle arthritis include total ankle replacement and ankle Arthrodesis. Although Arthrodesis is a reliable procedure, ankle replacement is often preferred by patients. This prospective study evaluated intermediate-term outcomes of ankle replacement and Arthrodesis in a large cohort at multiple centers, with variability in ankle arthritis type, prosthesis type, surgeon, and surgical technique. We hypothesized that patient-reported clinical outcomes would be similar for both procedures. Methods: Patients in the Canadian Orthopaedic Foot and Ankle Society (COFAS) Prospective Ankle Reconstruction Database were treated with total ankle replacement (involving Agility, STAR, Mobility, or HINTEGRA prostheses) or ankle Arthrodesis by six subspecialty-trained orthopaedic surgeons at four centers between 2001 and 2007. Data collection included demographics, comorbidities, and the Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) scores. The preoperative and latest follow-up scores for patients with at least four years of follow-up were analyzed. Sensitivity analyses excluded ankles that had undergone revision. A linear mixed-effects regression model compared scores between the groups, adjusting for age, sex, side, smoking status, body mass index, inflammatory arthritis diagnosis, baseline score, and surgeon. Results: Of the 388 ankles (281 in the ankle replacement group and 107 in the Arthrodesis group), 321 (83%; 232 ankle replacements and eighty-nine arthrodeses) were reviewed at a mean follow-up of 5.5 ± 1.2 years. Patients treated with Arthrodesis were younger, more likely to be diabetic, less likely to have inflammatory arthritis, and more likely to be smokers. Seven (7%) of the arthrodeses and forty-eight (17%) of the ankle replacements underwent revision. The major complications rate was 7% for Arthrodesis and 19% for ankle replacement. The AOS total, pain, and disability scores and SF-36 physical component summary score improved between the preoperative and final follow-up time points in both groups. The mean AOS total score improved from 53.4 points preoperatively to 33.6 points at the time of follow-up in the Arthrodesis group and from 51.9 to 26.4 points in the ankle replacement group. Differences in AOS and SF-36 scores between the Arthrodesis and ankle replacement groups at follow-up were minimal after adjustment for baseline characteristics and surgeon. Conclusions: Intermediate-term clinical outcomes of total ankle replacement and ankle Arthrodesis were comparable in a diverse cohort in which treatment was tailored to patient presentation; rates of reoperation and major complications were higher after ankle replacement. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Peer Review This article was reviewed by the Editor-in-Chief and one Deputy Editor, and it underwent blinded review by two or more outside experts. It was also reviewed by an expert in methodology and statistics. The Deputy Editor reviewed each revision of the article, and it underwent a final review by the Editor-in-Chief prior to publication. Final corrections and clarifications occurred during one or more exchanges between the author(s) and copyeditors.
