Joint Replacement vs Reconstruction

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

Disclaimer:

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.
 

Image Credits: coleofduty.com

“Health is the greatest gift, contentment the greatest wealth, faithfulness the best relationship.”- Buddha

Our bodies are physical mechanisms that  are utilised on a daily basis. With general living, and with the incorporation of physical activity, the body can be exposed to wear and tear. The joints are particularly susceptible to wear and tear. There are various factors that can lead to the development of joint pain. With time, our joints can develop stresses and strains that lead to the wearing away of the critical elements such as the cartilage. Cartilage is one of those critical components that keep the joint operating smoothly. Natural conditions such as ageing, and activities such as sports, can initiate joint pain and ultimately dissolve the joint elements. 

Patients who suffer from joint pain, experience difficulty in the execution of critical tasks such as walking, climbing stairs or inclines, or even motion after sitting for a long period of time. Advances in orthopaedic technologies have made it easier to recover from the symptoms of joint pain. There are various procedures that can be utilised by your orthopaedic surgeon in order to treat your existing condition. 

In the orthopaedic realm, the two surgical options that exist to alleviate joint pain are joint reconstruction and joint replacement surgery. There is an age-old debate about which one is better for the patient. Fortunately, we do have criteria that will enable us to identify a decision point that will determine which of the processes will work best for us. Some of the critical parameters that are involved in the determination of the appropriate procedure include: 

  1. Age – depending on your age one procedure will be more feasible than the other.
  2. Weight – depending on your weight and the extent of damage to the joint, it may be lucrative for one procedure over the next. 
  3. Muscle Strength – this will impact joint integrity

A decision matrix outlined by your orthopaedic surgeon will determine which of the methods will work best for you. Let us now delve into the two methodologies and identify which one would work best for your joint pain. 

Joint Reconstruction

As the name suggests, the joint reconstruction process involves the rebuilding of the joint. New surgical procedures are being developed over time that will optimise this procedure and make it a prime contender to joint reconstruction. Where possible, skilled surgeons do make an effort to salvage a limb or a joint, instead of having to replace the part. This process could take place either in holes, or in parts of the joint cavity. Orthopaedic surgeons will often determine their plan of action. Joint reconstruction has the advantages of: 

  1. Temporary Relief – in terms of the procedure, joint reconstruction can provide relief. The robustness of the procedure compared to joint replacement is to a lesser extent. 
  2. Recovery times however, are usually shorter and easier. There will also be an associated cost to the procedure which will vary in comparison to the joint replacement. 

The parts of the body that are often treated via reconstructive surgery are places like the ankle, elbow, shoulder, knee and the hip. 

Joint Replacement Surgery

Depending on the severity of the joint pain experienced, the severity of the pain and the extent of joint degradation may result in the orthopaedic surgeon suggesting a total joint replacement. A joint replacement can keep a patient pain free for up to ten years. This could be the best way to get rid of the pain for good. The ideal candidates for joint replacement surgery typically are those persons who are in the later stages of osteoarthritis. The surgical process is often identified as a last resort. The knees are key target areas for joint replacement surgery. 

During this process, the replacement parts for the joints are built from prosthetic biomaterials. Much like orthopaedic scaffolds, the parts will be a fusion of metal and plastic components. 

Once the surgeon has completed the joint replacement surgery, patients usually see results after the appropriate post operative care and healing procedures. 

If you are a candidate that experiences pain due to osteoarthritis, inflammatory conditions such as gout, or even trauma either of these methods will work well for you. An orthopaedic consult will usually determine the path of best healing. 

Reference Articles: 

  1. Joint Reconstruction and Replacement: https://www.orthomedctr.com/joint-reconstruction-and-replacement.php
  2. Joint Reconstruction Versus Replacement: https://www.movementortho.com/2017/03/31/joint-reconstruction-versus-replacement/
  3. Joint Reconstruction Vs Replacement: https://www.advancedboneandjoint.com/joint-reconstruction-vs-joint-replacement/

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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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