title: Comparison of distraction arthroplasty alone versus combined with arthroscopic microfracture in treatment of post-traumatic ankle arthritis.
abstract: BACKGROUND
  This study aims to compare clinical outcomes of distraction arthroplasty alone versus combined with arthroscopic microfracture in treating post-traumatic ankle arthritis.
  
  
  METHODS
  The study cohort consisted of 96 patients (96 ankles) who underwent distraction arthroplasty alone or combined with arthroscopic microfracture between May 2005 and April 2012. Patients were divided into the distraction group (n = 46) and the combined group (n = 50). The American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analog scale (VAS), and ankle activity score (AAS) were used to compare the clinical outcomes between groups. Arthritis severity was assessed on the radiograph.
  
  
  RESULTS
  At the mean follow-up period of 30.8 ± 3.1 and 31.4 ± 3.6 months, respectively, no severe complications occurred and no further surgical interventions for symptomatic arthritis were required in both groups. The AOFAS scores improved significantly in the combined group than in the distraction group (59.0 ± 4.7 and 58.0 ± 4.9 preoperatively versus 85.0 ± 4.9 and 88.9 ± 5.4 at final visit, P < 0.001). The AAS scores were also significantly higher in the combined group (3.6 ± 1.1 and 3.3 ± 1.0 preoperatively versus 6.5 ± 1.1 and 7.1 ± 1.3 at final visit, P = 0.009). Pain was significantly alleviated in the combined group by the VAS scores (6.4 ± 0.9 and 6.7 ± 0.9 preoperatively versus 2.3 ± 0.8 and 2.0 ± 0.7 at final visit, P = 0.040). The combined group achieved better radiographic arthritis severity decrease than the distraction group (P = 0.012).
  
  
  CONCLUSIONS
  Compared to distraction arthroplasty alone, distraction arthroplasty combined with arthroscopic microfracture can offer better functional recovery, pain relief, and ankle arthritis resolution for treating post-traumatic ankle arthritis.
authors.affiliation: Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, Nanjing, 210000, Jiangsu Province, People's Republic of China.
authors.forename: Kaibin
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, Nanjing, 210000, Jiangsu Province, People's Republic of China.
authors.forename: Yiqiu
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, Nanjing, 210000, Jiangsu Province, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Du
authors.affiliation: Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, Nanjing, 210000, Jiangsu Province, People's Republic of China.
authors.forename: Tianqi
authors.initials: T
authors.lastname: Tao
authors.affiliation: Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, Nanjing, 210000, Jiangsu Province, People's Republic of China.
authors.forename: Wang
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, Nanjing, 210000, Jiangsu Province, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, ChangLe Road 68, Nanjing, 210000, Jiangsu Province, People's Republic of China. gui1997@126.com.
authors.forename: Jianchao
authors.initials: J
authors.lastname: Gui
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000150:complications*; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods* / Q000534:rehabilitation; D001182:Arthroscopy / Q000379:methods* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D010147:Pain Measurement; D011859:Radiography; D020127:Recovery of Function; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ankle arthritis; Arthroscopy; Cartilage; Distraction arthroplasty; Microfracture