title: Ankle arthrodesis vs TTC arthrodesis: patient outcomes, satisfaction, and return to activity.
abstract: BACKGROUND
  It is believed that patients with an ankle arthrodesis (AA) have better outcomes than after a tibiotalocalcaneal (TTC) arthrodesis due to preservation of subtalar motion. However, there are no studies comparing actual functional outcomes and patient satisfaction between AA and TTC arthrodesis.
  
  
  METHODS
  We retrospectively analyzed patient satisfaction and functional outcomes of patients after an AA and TTC arthrodesis using a postal survey. A total of 173 patients who underwent TTC and 100 AA patients from 2002 to 2010 were identified with a minimum of 24 months follow-up. In all, 53 AA and 64 TTC arthrodesis patients were included in the study, with the remainder lost to follow-up. A return to activity questionnaire and SF-12 scores were used to compare functional outcomes. The mean follow-up time was 63 months.
  
  
  RESULTS
  Both groups showed good outcomes with a low visual analogue pain score (2.7 for AA and 2.8 for TTC), high satisfaction score (90.6% for AA and 87.5% for TTC), and return to work (77.4% for AA and 73.0% for TTC). In all, 84.6% of AA and 81.0% of TTC patients would have the surgery again. There were no significant differences between the 2 groups for these parameters. However, when asked if their desired activity level was met, fewer AA patients met their desired level (58.5% for AA and 66.5% for TTC, P = .02). AA patients were also more likely to feel their level was unmet due to the foot and ankle (85.6% for AA vs 25.7% for TTC, P < .001).
  
  
  CONCLUSIONS
  Both AA and TTC arthrodesis were associated with good functional outcomes and satisfaction. AA patients had higher postoperative activity expectations and were less likely to meet them. When they failed to meet these expectations, they were much more likely to attribute it to their operated ankle. We believe it is because of the different ways the 2 groups of patients are counseled preoperatively, which highlights the importance of managing patient expectations.
  
  
  METHODS
  Level III, retrospective comparative study.
authors: Wirral University Teaching Hospital NHS Trust, Sandymoor, UK.
authors: Adam
authors: A
authors: Ajis
authors: Ken-Jin
authors: KJ
authors: Tan
authors: Mark S
authors: MS
authors: Myerson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint; D001168:Arthritis / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D001174:Arthrodesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D017060:Patient Satisfaction; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D013640:Tarsal Joints; D016896:Treatment Outcome; D055815:Young Adult
keywords: TTC fusion; ankle fusion; subtalar fusion; tibiotalocalcaneal fusion