title: Distinctive pain course during first year after total ankle arthroplasty: a prospective, observational study.
abstract: BACKGROUND
  Patients and health care professionals alike are often surprised by the course of pain after total ankle arthroplasty (TAA). The current study aimed to determine the baseline patterns of postoperative symptoms during the first year following uncomplicated TAA.
  
  
  METHODS
  In a prospective observational study 28 patients with unilateral posttraumatic osteoarthritis were tested for pain with a visual analogue scale, swelling (min grade, 0; max grade, 4), ankle range of motion, and AOFAS ankle score. Assessments were performed preoperatively and 6 weeks, 3, 6, 9, and 12 months after TAA.
  
  
  RESULTS
  At 6 weeks all variables had improved significantly. However, at 3 months a relapse with deterioration of mean variables was found. These improved asymptotically during assessments at 6, 9, and 12 months.
  
  
  CONCLUSIONS
  Our data suggest patients undergoing uncomplicated TAA have to overpass what we believe is an adaptive inflammatory phase with increased periarticular pain and swelling about 3 months after surgery. This distinctive course may influence patient education and increase confidence of healthcare professionals involved in the rehabilitation of TAA patients.
authors.affiliation: Department of Orthopaedic Surgery, University Clinics of Basel, Spitalstr. 21, CH-4031 Switzerland. gpagenstert@bluewin.ch
authors.forename: Geert
authors.initials: G
authors.lastname: Pagenstert
authors.forename: Monika
authors.initials: M
authors.lastname: Horisberger
authors.forename: André G
authors.initials: AG
authors.lastname: Leumann
authors.forename: Martin
authors.initials: M
authors.lastname: Wiewiorski
authors.forename: Beat
authors.initials: B
authors.lastname: Hintermann
authors.forename: Victor
authors.initials: V
authors.lastname: Valderrabano
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D058737:Arthroplasty, Replacement, Ankle / Q000009:adverse effects*; D004487:Edema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012008:Recurrence; D013997:Time Factors; D016138:Walking