title: Cement arthroplasty for ankle joint destruction.
abstract: BACKGROUND
  The aim of this study was to investigate the outcomes of cement arthroplasty used as a primary salvage procedure to treat ankle joint destruction.
  
  
  METHODS
  This study included sixteen patients who underwent primary cement arthroplasty from May 2004 to March 2012 because of an ankle disorder, including intractable infection, nonunion, or a large bone defect or tumor. The mean age of the patients was fifty-seven years (range, twenty-three to seventy-four years), and the mean follow-up period was thirty-nine months (range, fourteen to 100 months). The cement spacer position, cement breakage, osteolysis around the inserted cement, and alignment of the joint were evaluated radiographically. American Orthopaedic Foot & Ankle Society (AOFAS) scores and visual analogue scale (VAS) pain scores were recorded preoperatively and at the time of final follow-up. Functional questionnaires were used to assess the duration for which the patient could walk continuously, use of walking aids, sports activity, consumption of pain medication, and the patient's subjective assessment of the percentage of overall improvement compared with before the cement arthroplasty.
  
  
  RESULTS
  The cement spacer was retained without breakage for a mean of thirty-nine months (range, fourteen to 100 months). Osteolysis around the cement was observed in one patient at seventy-eight months, and subluxation developed in one patient. The mean AOFAS and VAS pain scores improved from 39 (range, 11 to 71) preoperatively to 70 (range, 47 to 88) postoperatively (p = 0.001) and from 8 (range, 4 to 9) to 3 (range, 1 to 7) (p = 0.001), respectively. At the final follow-up evaluation, nine of the sixteen patients did not require walking aids, ten used no pain medication, and nine were able to walk continuously for more than an hour. One patient complained of persistent pain and was considered to have had a failure of the procedure.
  
  
  CONCLUSIONS
  Primary cement arthroplasty might be a treatment option for advanced ankle destruction in elderly and less active patients.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Foot and Ankle Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, South Korea. E-mail address for H.-S. Lee: hosng@amc.seoul.kr.
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Foot and Ankle Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, South Korea. E-mail address for H.-S. Lee: hosng@amc.seoul.kr.
authors.forename: Ji-Yong
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Department of Orthopaedic Surgery, Foot and Ankle Surgery, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, South Korea. E-mail address for H.-S. Lee: hosng@amc.seoul.kr.
authors.forename: Jong-Seok
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Foot and Ankle Surgery, Chosun University School of Medicine, Gwangju, South Korea.
authors.forename: Jun-Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Foot and Ankle Surgery, The Catholic University of Korea, Daejeon St. Mary's Hospital, Daeheung-dong, jung-gu, Daejeon, South Korea.
authors.forename: Jae-Jung
authors.initials: JJ
authors.lastname: Jeong
authors.affiliation: Department of Orthopaedic Surgery, Foot and Ankle Surgery, CHA Bundang Medical Center, CHA University, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
authors.forename: Young Rak
authors.initials: YR
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods*; D001843:Bone Cements / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery; D002484:Cementation / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000473:pathology / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D061214:Patient Safety; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001843:Bone Cements