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Residual pain due to soft-tissue impingement after uncomplicated total ankle replacement

Authors
 B. S. Kim  ;  W. J. Choi  ;  J. Kim  ;  J. W. Lee 
Citation
 JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME , Vol.95B(3) : 378-383, 2013 
Journal Title
 JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME 
ISSN
 0301-620X 
Issue Date
2013
MeSH
Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Ankle* ; Arthroscopy ; Cicatrix, Hypertrophic/complications* ; Cicatrix, Hypertrophic/diagnosis ; Cicatrix, Hypertrophic/epidemiology ; Cicatrix, Hypertrophic/surgery ; Debridement/methods ; Follow-Up Studies ; Humans ; Incidence ; Middle Aged ; Pain Measurement ; Pain, Postoperative/diagnosis ; Pain, Postoperative/epidemiology ; Pain, Postoperative/etiology* ; Pain, Postoperative/surgery ; Patient Satisfaction ; Prevalence ; Synovial Membrane/pathology* ; Treatment Outcome
Keywords
Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Ankle* ; Arthroscopy ; Cicatrix, Hypertrophic/complications* ; Cicatrix, Hypertrophic/diagnosis ; Cicatrix, Hypertrophic/epidemiology ; Cicatrix, Hypertrophic/surgery ; Debridement/methods ; Follow-Up Studies ; Humans ; Incidence ; Middle Aged ; Pain Measurement ; Pain, Postoperative/diagnosis ; Pain, Postoperative/epidemiology ; Pain, Postoperative/etiology* ; Pain, Postoperative/surgery ; Patient Satisfaction ; Prevalence ; Synovial Membrane/pathology* ; Treatment Outcome
Abstract
We report the incidence and intensity of persistent pain in patients with an otherwise uncomplicated total ankle replacement (TAR). Arthroscopic debridement was performed in selected cases and the clinical outcome was analysed. Among 120 uncomplicated TARs, there was persistent pain with a mean visual analogue scale (VAS) of 2.7 (0 to 8). The intensity of pain decreased in 115 ankles (95.8%). Exercise or walking for more than 30 minutes was the most common aggravating factor (62 ankles, 68.1%). The character of the pain was most commonly described as dull (50 ankles, 54.9%) and located on the medial aspect of the joint (43 ankles, 47.3%). A total of seven ankles (5.8%) underwent subsequent arthroscopy. These patients had local symptoms and a VAS for pain ≥ 7 on exertion. Impingement with fibrosis and synovitis was confirmed. After debridement, the median VAS decreased from 7 to 3 and six patients were satisfied. The median VAS for pain and the American Orthopaedic Foot and Ankle Society score of the ankles after debridement was similar to that of the uncomplicated TARs (p = 0.496 and p = 0.066, respectively). Although TAR reduces the intensity of pain, residual pain is not infrequent even in otherwise uncomplicated TARs and soft-tissue impingement is the possible cause.
Full Text
http://www.bjj.boneandjoint.org.uk/content/95-B/3/378.long
DOI
10.1302/0301-620X.95B3.31219
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Jin Woo(이진우) ORCID logo https://orcid.org/0000-0002-0293-9017
Choi, Woo Jin(최우진)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86588
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