A Survey for End-Stage Ankle Arthritis Treatment: Ankle Arthrodesis Versus Ankle Arthroplasty |
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| Affiliation: | 1. Research Assistant, Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON;2. Research Assistant, EnCORE Research, Burlington, ON;3. Assistant Professor, Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON;4. Orthopaedic Surgeon, Department of Orthopaedic Surgery, University of Missouri, Columbia, MO;5. Physiotherapist, EnCORE Research, Burlington, ON;6. Professor & Orthopaedic Surgeon, Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON;7. Professor & Orthopaedic Surgeon, Department of Surgery, McMaster University, Hamilton, ON;1. Resident, Atrium Health, Charlotte, NC;2. Attending Surgeon, OrthoCarolina Foot and Ankle Institute, Charlotte, NC;1. Podiatric Surgeon, Emory Decatur Hospital, Decatur, GA;2. Podiatric Surgeon, Metro Foot and Ankle Centers, PC, Lithonia, GA;3. Infectious Disease Physician, Infectious Disease Specialists of Atlanta, Emory Decatur Hospital, Decatur, GA;4. Podiatric Surgeon, Emory Podiatry at Emory Decatur Hospital, Decatur, GA;5. Podiatric Surgeon, Emory Decatur Hospital, Decatur, GA;1. Resident, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD;2. Assistant Professor, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD;3. Associate Professor, Department of Pathology, Marshall University School of Medicine, Huntington, WV;4. Professor, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD;1. Resident, Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center Mercy, Pittsburgh, PA;2. Associate, Centers for Advanced Orthopaedics, Catonsville, MD;3. Associate, Foot Healthcare Associates, Livonia, MI;4. Assistant Professor, Podiatric Medicine and Surgery Residency, Department of Orthopedic Surgery, University of Pittsburgh Medical Center Mercy, University Pittsburgh School of Medicine, Pittsburgh, PA |
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| Abstract: | With promising technological advances, ankle arthroplasty has become an alternative to arthrodesis, traditionally the gold standard, for treating end-stage ankle arthritis. We collected knowledge and perceptions on both procedures to determine the need for a patient decision aid for these patients by administering a cross-sectional survey to 103 orthopaedic surgeons. Respondents were predominantly male and 41 to 50 years old. Half of those who stated that they do not perform arthroplasty said this was because they do not have adequate training. Additionally, certain variables were associated with the surgeon's choice of intervention: patient gender, age, body mass index, postoperative activity level, employment type, perceived risk of infection, neurovascular injury or wound complication, risk of developing or pre-existing adjacent arthritis, deformity, malalignment, bone loss or abnormal bone quality, number of prior ankle operations, cause of arthritis, and desire for motion preservation. The majority agreed that they always incorporate patient preferences into their decisions and that a decision aid would be beneficial. This survey revealed that several patient characteristics are influential in the surgeon's preference for either arthroplasty or arthrodesis for end-stage ankle arthritis. Because the majority of surgeons incorporate patient preferences in their decisions and report that a decision aid would be beneficial for informed decision-making in this clinical scenario, this survey identified an unmet need supporting the development of such a tool for these patients. |
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