Ankle distraction arthroplasty with platelet-rich plasma injection for post-traumatic ankle arthritis

Abstract

Objective To evaluate the surgical techniques and clinical outcomes of ankle distraction arthroplasty with platelet-rich plasma (PRP) injection for post-traumatic ankle arthritis. Methods From May 2012 to May 2017, 32 patients with post-traumatic ankle arthritis were treated at Department of Or-thopaedic Surgery, Shanghai Sixth People’s Hospital.They were 22 males and 10 females, with an age of 32.6±5.8 years (from 18 to 40 years).Their course of disease was 14.0±2.8 months (from 6 to 24 months).After failure of the conservative management for at least 6 months, they received ankle distraction arthroplasty with PRP injection.American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) were used to evaluate the final overall outcomes.Range of motion (ROM) of the ankle joint and complications were also recorded postoperatively. Results Pin tract infection occurred in 12 patients but responded to alcohol care.All the patients were followed up for an average of 36 months (from 18 to 60 months).The VAS score decreased significantly from preoperative 6.8±1.2 to postoperative 1.8±1.4; the AOFAS ankle-hindfoot score increased significantly from preoperative 38.5±6.2 to 80.3±8.1 at the final follow-up; dorsal expansion and plantar flexion of the ankle increased significantly from pre-operative 8.3°±7.0° and 24.7°±6.4° to 12.8°±6.5° and 31.4°±5.3° at the final follow-up, respectively(all P<0.05).Two patients had to receive salvage arthrodesis after conservative management failed to re-lieve their symptoms or delay the progression of their post-traumatic arthritis. Conclusion Ankle dis-traction arthroplasty with PRP injection is an effective ankle preserving surgery which can relieve symptoms, improve functions and delay progression of post-traumatic ankle arthritis. Key words: Ankle joint; Arthritis; Arthroplasty; Platelet-rich plasma