Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years


This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.


Compliments of the Season to You!

Here at the blog, we’ve spent the past few months sharing with you as much information as we possibly can about how to take care of your feet. As we reflect on the year that was, we simultaneously look towards the future that will be. It is with our pleasure that we’d like to announce that Dr Gordon Slater is now the Editor in Chief of the Journal of Regenerative Biology and Medicine.

As a renowned Open Access Journal, there is a wealth of information to be gleaned from the utilization of this source. If you’re a researcher, or wanting to know more in depth details of health care, feel free to peruse the publication. For your reading pleasure, a recent editorial is outlined below:

Foetal Healing Cascade – Can We Duplicate It In Adults?

The scientific study of medicine, is all about the science of healing. Whether the focus be on the mind or body, the fascination with prolonging life, improving the quality of life, and generating new life is a theme that will perpetuate the human experience. Organisms are self-contained growth and healing mechanisms. Science has marvelled for years on how these healing processes work, so that they can be engineered into the right circumstances to restore anything from joint cartilage, ligaments, blood vessels, muscles and bones. 

A case in point is the healing mechanism of the skin. As the human body’s largest organ, whenever a weakness known as a wound is introduced either via stresses or strains that cause a tear in that external surface, the body immediately identifies a point of weakness, and gets to work to repair itself. Designed to protect itself from external dangers such as viruses and bacteria, the immune system immediately induces a series of mechanisms of cascading cellular functions, which integrate to restore their host. Healing and regeneration are part of the grand design, especially for a life that is now expected to span into the life ranges of up to one hundred years old with the current state of medicine.

With the advent of medicine, life spans are indeed expanding. What if it is possible to be eighty and still be able to run a marathon? How will that be possible? With healing processes, regeneration processes and appropriate nutrition, it will be possible for the human body to sustain itself for much longer than originally anticipated. With a better understanding of science, the human experience can be fully optimized. You can generate a brand new you, with the help of your team of doctors. 

Adult skin wound healing mechanisms have been studied by scientists for decades. As a process that is highly regulated, many cellular, humoral and molecular mechanisms are at play in the closure of the wound. There is a seemingly graceful dance or interplay of all these various elements that creates this final result. When the balance between cells and healing mediators is disturbed however, the wound healing mechanisms can be affected and relevant restorative processes take significantly longer to facilitate than in a normal adult or even in a child. Medical science has identified that the healing properties of a life inducing agent such as a stem cell, when introduced into an adult wound site, can vastly improve the healing and generating capabilities of that adult. In orthopaedics, joint restoration is an experience that many are enjoying today, thanks to the advent of the utilization of stem cells and human growth factors. 

If it seems as if we have found the fountain of youth, at this point it is too early to tell. Much like in the advent of much of today’s technologies, the best way to optimize an organism is to naturally generate a new one. For the living organisms that exist however, making the life experience a more enjoyable one, is what science, technology and medicine are all about. Regeneration in plants and animals is a phenomenon that many are aware of. In the mammalian realm for instance, many are taught that certain worms and even starfish can regenerate limbs if the limbs themselves are severed in a bout of self defence. The root causes of the healing and regenerative traits of these species were traced to their cell’s blastema. The blastema contain life sustaining progenitor cells. As scientists studied these healing mechanisms in the animal kingdom, they were able to trace almost identical healing mechanisms within humans as well. Identifying the root of healing, enabled bioengineering processes to be introduced into the body and the regeneration of the body from seeming serious injuries. 

The foetal healing cascade, was identified approximately thirty five years ago, as a means via which the mammalian classification, inclusive of humans was able to promote regeneration of life functions. In trialled infant human patients, studies have identified that healing mechanisms such as minimization of scars took place rapidly compared to an adult.  Additionally, during the study of the healing process, observations such as reduction of the inflammatory processes that are natural during adult wound healing were found to be reduced in infant subjects. The root causes of the difference between adult and child healing mechanisms was linked to increased activity of inflammatory reducing agents such as inflammatory cytokines.  

Additionally as science has subsequently identified, foetal inflammatory cells are found to be less differentiated than those of an adult. Stem cell theory also supports this fact. When needed, stem cells can evolve into the desired cells necessary to restore the wounded site. The inflammation processes are just one differentiating factor between foetal and adult wound healing mechanisms. As different growth factors are engaged by both mechanisms, the advanced rates of one can be used to catalyze the seeming reduced rates of the latter. Regeneration processes benefit greatly from an integration of the two healing forces. Much like in the case of non-mammalian studies, progenitor cells are prolific in foetal systems, compared to the adult healing systems where they are reduced with age. 

While the regulation of the healing mechanism during healing and regeneration is a rather complex mechanism, decades of study have improved our understanding of the process responsible for the primary healing mechanisms. As research is expanding, the foetal healing cascade will be integral to facilitating the regeneration of many downstream human conditions, particularly where healing deficiencies exist. With new knowledge, will come new applications and inventions in all aspects of healing that will facilitate the wound healing process. The principles at their core simply imply that life restoration involves returning to our biological “roots”.

Reference Articles for Scientific References: 

  1. Wound Repair and Regeneration: https://www.karger.com/Article/FullText/339613
  2. Musculoskeletal regeneration and its implications for the treatment of tendinopathy: https://onlinelibrary.wiley.com/doi/full/10.1111/iep.12031

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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