title: Intermediate-term follow-up after ankle distraction for treatment of end-stage osteoarthritis.
abstract: BACKGROUND
  Treatment of end-stage ankle osteoarthritis remains challenging, especially in young patients. Initial reports have shown early benefits of joint distraction for the treatment of ankle osteoarthritis. We report the five to ten-year results of a previously described patient cohort following ankle distraction surgery.
  
  
  METHODS
  All thirty-six patients who had undergone ankle distraction surgery between December 2002 and October 2006 were contacted. Patients were evaluated by a clinical investigator and completed the Ankle Osteoarthritis Scale (AOS) and Short Form-36 (SF-36) surveys. Radiographs as well as computed tomography and magnetic resonance imaging scans of the ankles were obtained at the follow-up visits.
  
  
  RESULTS
  Twenty-nine patients (81%) were followed for a minimum of five years (mean and standard deviation, 8.3 ± 2.2 years). Sixteen (55%) of the twenty-nine patients still had the native ankle joint whereas thirteen patients (45%) had undergone either ankle arthrodesis or total ankle arthroplasty. Positive predictors of ankle survival included a better AOS score at two years (hazard ratio [HR] = 0.048, 95% confidence interval [CI] = 0.0028 to 0.84, p = 0.04), older age at surgery (HR = 0.91, 95% CI = 0.83 to 0.99, p = 0.04), and fixed distraction (HR = 0.094, 95% CI = 0.017 to 0.525, p < 0.01). Radiographs and advanced imaging revealed progression of ankle osteoarthritis at the time of final follow-up.
  
  
  CONCLUSIONS
  Ankle function following joint distraction declines over time. Patients should be well informed of the commitment that they must make during the treatment period as well as the long-term results after surgery.
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for M.P. Nguyen: Mai-nguyen@uiowa.edu. E-mail address for D.R. Pedersen: Doug-pedersen@uiowa.edu. E-mail address for Y. Gao: Yubo-gao@uiowa.edu. E-mail address for A. Amendola: Ned-amendola@uiowa.edu.
authors.forename: Mai P
authors.initials: MP
authors.lastname: Nguyen
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for M.P. Nguyen: Mai-nguyen@uiowa.edu. E-mail address for D.R. Pedersen: Doug-pedersen@uiowa.edu. E-mail address for Y. Gao: Yubo-gao@uiowa.edu. E-mail address for A. Amendola: Ned-amendola@uiowa.edu.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Pedersen
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for M.P. Nguyen: Mai-nguyen@uiowa.edu. E-mail address for D.R. Pedersen: Doug-pedersen@uiowa.edu. E-mail address for Y. Gao: Yubo-gao@uiowa.edu. E-mail address for A. Amendola: Ned-amendola@uiowa.edu.
authors.forename: Yubo
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108. E-mail address: Charles.saltzman@hsc.utah.edu.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Saltzman
authors.affiliation: Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for M.P. Nguyen: Mai-nguyen@uiowa.edu. E-mail address for D.R. Pedersen: Doug-pedersen@uiowa.edu. E-mail address for Y. Gao: Yubo-gao@uiowa.edu. E-mail address for A. Amendola: Ned-amendola@uiowa.edu.
authors.forename: Annunziato
authors.initials: A
authors.lastname: Amendola
mesh_terms: D000293:Adolescent; D000328:Adult; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019857:Osteogenesis, Distraction; D016016:Proportional Hazards Models; D014057:Tomography, X-Ray Computed; D055815:Young Adult
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