Sports and recreation activity of ankle arthritis patients before and after total ankle replacement

BACKGROUND: Total ankle replacement is a possible treatment for ankle arthritis; however, participation in sports after this procedure has not yet been analyzed. HYPOTHESES: There is a significant increase of sports activity after total ankle replacement in patients with arthritis. There is a significant correlation between sports activity and American Orthopaedic Foot and Ankle Society hindfoot score in patients after total ankle replacement. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A clinical evaluation was performed preoperatively and at follow-up after total ankle replacement in 147 patients (152 ankles) with ankle arthritis (mean age, 59.6 years; range, 28-86 years). Ankle arthritis origin, patient satisfaction, range of motion, American Orthopaedic Foot and Ankle Society hindfoot score, radiologic assessment, and rate, level, and type of sports activity were documented at both evaluations. The mean follow-up was 2.8 years (range, 2-4 years). RESULTS: Preoperative diagnosis was posttraumatic osteoarthritis in 115 cases (76%). At total ankle replacement follow-up, excellent and good outcomes were reported in 126 cases (83%); 105 cases (69%) were pain free. The mean range of motion pre-operatively was 21 degrees (range, 0 degrees -45 degrees ); after total ankle replacement, it was 35 degrees (range, 10 degrees -55 degrees ; P < .05). The preoperative American Orthopaedic Foot and Ankle Society score was 36 points; after total ankle replacement, it was 84 points (P < .001). Before surgery, 36% of the patients were active in sports; after surgery, this percentage rose to 56% (P < .001). After total ankle replacement, sports-active patients showed a significantly higher hindfoot score than did patients not active in sports: 88 versus 79 points (P < .001). The 3 most frequent sports activities were hiking, biking, and swimming. CONCLUSION: There was a significant increase of sports activity by treating ankle arthritis patients with total ankle replacement. Sports-active total ankle replacement patients showed better functional results than did inactive ones.