족관절 인공관절 치환술 후 관리 및 재활 = Total Ankle Arthroplasty Management and Rehabilitation

다국어 초록 (Multilingual Abstract)

Although total ankle arthroplasty (TAA) has increased considerably in the past ten years, reflecting improvements in implant design and survivorship, the clinical outcomes have been less satisfactory than total hip or total knee arthroplasties. Several issues under debate include postoperative management and rehabilitation in TAA. Especially, there is no consensus or evidence for the most appropriate postoperative management and rehabilitation for patients undergoing TAA. This study was therefore undertaken to suggest appropriate postoperative management and rehabilitation in TAA, after reviewing published articles and focusing on the following topics: prehabilitation, hospital stay, immobilization type and duration, weight-bearing management, pharmacological treatment, and adopted rehabilitation protocols. In previous studies, the postoperative management and rehabilitation proposed depended on the surgeon’s preference, the patient's characteristics, and the associated surgical procedures performed after TAA. Nonetheless, our research indicates the best approach is to include a prehabilitation program, immobilization in the early postoperative stage (2~4 weeks), range of motion exercise with partial weight-bearing ambulation, followed by full weight-bearing ambulation after six weeks. Further studies are required to develop a standardized rehabilitation protocol and improve the overall quality of care after TAA.

참고문헌 (Reference)

1 Jones C, "Understanding the postoperative course and rehabilitation protocol for total ankle arthroplasty" 8 : 203-208, 2015

2 Bueno H, "Trends in length of stay and short-term outcomes among Medicare patients hospitalized for heart failure, 1993-2006" 303 : 2141-2147, 2010

3 Prusinowska A, "Total ankle replacement-surgical treatment and rehabilitation" 53 : 34-39, 2015

4 Saltzman CL, "Total ankle replacement revisited" 30 : 56-67, 2000

5 Hintermann B, "Total ankle replacement for treatment of end-stage osteoarthritis in elderly patients" 2012 : 345237-, 2012

6 Massobrio M, "Total ankle replacement : indications, rehabilitation and results" 2 : 019-, 2018

7 Cody EA, "Total ankle arthroplasty : a critical analysis review" 6 : e8-, 2018

8 Gocen Z, "The effect of preoperative physiotherapy and education on the outcome of total hip replacement : a prospective randomized controlled trial" 18 : 353-358, 2004

9 Roukis TS, "The Salto Talaris XT revision ankle prosthesis" 32 : 551-567, 2015

10 Brink O, "Stable lateral malleolar fractures treated with aircast ankle brace and DonJoy R. O. M. -Walker brace : a prospective randomized study" 17 : 679-684, 1996

11 Avashia YJ, "Soft tissue reconstruction after total ankle arthroplasty" 22 : 391-404, 2017

12 Hofmann KJ, "Salto Talaris total ankle arthroplasty : clinical results at a mean of 5. 2 years in 78 patients treated by a single surgeon" 98 : 2036-2046, 2016

13 Barg A, "Risk factors for symptomatic deep-vein thrombosis in patients after total ankle replacement who received routine chemical thromboprophylaxis" 93 : 921-927, 2011

14 Frane N, "Return-to-driving recommendations after lower-extremity orthopaedic procedures" 8 : e20-, 2020

15 Bhowmik-Stoker M, "Return to work and driving after robotic arm-assisted total knee arthroplasty" 16 : 219-223, 2022

16 McDonald EL, "Return to driving after foot and ankle surgery : a novel survey to predict passing brake reaction time" 14 : 32-38, 2021

17 Giannini S, "Results at a minimum follow-up of 5 years of a ligaments-compatible total ankle replacement design" 23 : 116-121, 2017

18 Jaggers JR, "Prehabilitation before knee arthroplasty increases postsurgical function : a case study" 21 : 632-634, 2007

19 Ajis A, "Postoperative range of motion trends following total ankle arthroplasty" 34 : 645-656, 2013

20 Mazzotti A, "Post-operative management after total ankle arthroplasty : a systematic review of the literature" 28 : 535-542, 2022

21 Viste A, "Periprosthetic osteolysis after AES total ankle replacement : conventional radiography versus CT-scan" 21 : 164-170, 2015

22 Kotela A, "Perioperative physiotherapy for total ankle replacement in patients with inherited bleeding disorders : outline of an algorithm" 23 : 498-504, 2017

23 DiLiberto FE, "Overall health and the influence of physical therapy on physical function following total ankle arthroplasty" 41 : 1383-1390, 2020

24 Warwick D, "Insufficient duration of venous thromboembolism prophylaxis after total hip or knee replacement when compared with the time course of thromboembolic events : findings from the Global Orthopaedic Registry" 89 : 799-807, 2007

25 Cody EA, "Increased early revision rate with the INFINITY total ankle prosthesis" 40 : 9-17, 2019

26 Hsu AR, "Early clinical and radiographic outcomes of intramedullary-fixation total ankle arthroplasty" 97 : 194-200, 2015

27 Boylan MR, "Does total ankle arthroplasty belong in the comprehensive care for joint replacement?" 57 : 69-73, 2018

28 Hintermann B, "Dealing with the stiff ankle : preoperative and late occurrence" 22 : 425-453, 2017

29 Mayle RE Jr, "Current concepts review : venous thromboembolic disease in foot and ankle surgery" 28 : 1207-1216, 2007

30 Elliott AD, "Anterior incision offloading for primary and revision total ankle replacement : a comparative analysis of two techniques" 11 : 678-686, 2017

31 Jung HG, "Anterior heterotopic ossification at the talar neck after total ankle arthroplasty" 37 : 703-708, 2016

32 Phillips WA, "A prospective, randomized study of the management of severe ankle fractures" 67 : 67-78, 1985

33 Usuelli FG, "A modification of the fibular osteotomy for total ankle replacement through the lateral transfibular approach" 101 : 2026-2035, 2019