Indications of Total Ankle Replacement for Ankle Arthritis: The Evaluation of Quality of Life and Radiographic Findings

Objectives: Little is known about the quality of life and clear cut radiographic grades of ankle arthritis in patients with indication for the total ankle replacement (TAR) comparing with patients without indication for TAR. This study was to compare the quality of life and radiographic grades of ankle arthritis in patients who had ankle arthritis with and without indication for TAR. Methods: From January 2010 to November 2013, the evaluation was conducted on 23 patients aged 18 or older who had ankle arthritis from several causes. The 23 patients were divided into two groups according to their indications of TAR: TAR group (n=7 patients) and non-TAR group (n=16 patients). The medical records of each patient were reviewed to collect for the pre-treatment visual analogue scale (VAS-pain score), visual analogue scale foot and ankle (VAS-FA) score, health-related quality of life score via short-form 36 (SF-36), baseline data including age, gender, side of ankle arthritis, cause of arthritis, radiographic findings, and treatment methods. Results: There were no significant differences in the mean VAS-pain, VAS-FA, and SF-36 scores between the TAR and non-TAR groups (p>0.05). Poorer radiographic grades as Takakura grades 3-4 or the author's grades 3-4 were significantly higher in TAR group (p<0.001). SF-36 scores were significantly lower in patients with poorer radiographic grades in both Takakura (p=0.023) or Angthong (p=0.042) classifications. Conclusion: Although quality of life in patients with indication for TAR was not significantly poorer than patients without indication for TAR, radiographic grades in patients with indication for TAR were significantly poorer than patients without indication for TAR. Radiographic grades of ankle arthritis as Takakura grades 3-4 or the author's grades 3-4 are the clear cut criteria in combination with other accepted criteria to be indications for TAR.