The Effect of Sagittal and Coronal Balance on Patient-Reported Outcomes Following Mobile-Bearing Total Ankle Replacement

Total ankle replacement (TAR) is an established technique for the treatment of end-stage ankle arthritis. The aims of TAR include pain relief, preservation of tibiotalar movement, protection of adjacent joints, and restoration of anatomic alignment in the coronal and sagittal planes. The aims of this study were to determine the relative importance of pre- and post-TAR coronal and sagittal balance on postoperative patient-reported outcome measures (PROMs). A total of 101 ankles in 99 patients were included in this retrospective cohort study. Patients were scored preoperatively and at a minimum of 2 years by using the Foot and Ankle Outcome Score (FAOS), the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot-ankle score, the Short Form-36 measures, and a set of radiographic measurements to define the sagittal and coronal alignment. There was no significant difference between the groups regarding the anterior or posterior translation of the talus preoperatively. There were no statistically significant correlations between any preoperative measure and any domain of the PROM data. Significant correlations were observed between postoperative medial distal tibial angle and the function domain of the FAOS and the AOFAS hindfoot-ankle score. Preoperative coronal and sagittal plane deformity are not markedly different, depending on the diagnosis. Preoperative deformity does not appear to correlate significantly with postoperative function, as measured by the PROM scores. Postoperative sagittal plane alignment does not correlate significantly with postoperative function, as measured by PROMs. Coronal plane alignment, as measured by the medial distal tibial angle, may be associated with postoperative function, as measured on the AOFAS hindfoot-ankle and FAOS function subscales. (C) 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.