Prevention of Diabetes- Related Amputations

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.,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.

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“To ensure good health: eat lightly, breathe deeply, live moderately, cultivate cheerfulness, and maintain an interest in life.” -William Londen

Diabetes, as a health condition, has associated side effects that cause it to impact the mortality of the patients it affects, if the patient is not carefully monitored. Not all diabetic patients are the same! Assessing the patient categories will identify various downstream conditions! 

Whether a patient has Type 1 Diabetes, Type 2 Diabetes…the side effects are numerous!!

One side effect of diabetes is the condition known as diabetes-related foot diseases, also known as DFD. DFD is one of those health conditions that is so subtle, that it doesn’t get noticed until it’s in an advanced state. 

The final stages of DFD results in amputation of limbs, particularly feet. With amputations come an increase in mortality rates, and for both the patients longevity and ease of life, there is now an increased paradigm shift in how DFD is approached by the health industry. DFD statistically is the leading cause of amputations in Australia. The downstream effects are also propagated as the condition progresses. With a total expenditure of up to $1.6 billion each year, the financial benefits of reducing the adverse effects of DFD will not only be economical, but will facilitate the improvement of the quality of life of the patients who are saved. More research is still left to be carried out on the DFD condition. Mainly linked to either peripheral neuropathy or peripheral artery disease, the resulting neuropathy is what causes the patient to lose the sensation in their feet and ultimately develop ulcers that lead to amputations. 

The root cause of DFD is the loss in the sensation of the feet, so it is imperative for the feet to be carefully monitored as the patient progresses through their diabetic care. For this reason, more attention at the early stages of diabetes, must be paid to the feet. 

What are the next steps? 

Once DFD is diagnosed, the medical industry has identified that an integrated approach to DFD management is needed. The team needed will consist of the following professionals: 

  1. Medical
  2. Surgical 
  3. Nursing
  4. Allied Health Disciplines

The process must be integrated across all the tiers of the medical sector – primary, secondary and tertiary phases of the system. With appropriate treatment at each stage, the achievement of the prevention of amputation will be facilitated. The state of the Australian statistics is the nation is in the leading OECD nations for its amputation rates linked to diabetes. Compared to the EU nations, the gap is significant. Fortunately, the root cause of the difference has been attributed to the integrated systems which facilitate increased patient care. 

How will DFD related amputations be reduced? 

Policy changes are the key to changing the status quo of the Australian Health Care System. The business case for the reduction of the expenditure on DFD has peaked the attention of national bodies in Australia. The statistics for DFD have been collated over the past few years, and from the root cause analysis of the numbers recommendations for healing the system have been proposed. The interdisciplinary integrated systems have been added to the health care system. The resulting outcome is a halving in the amputation rates. 

Additionally, dedicated entities such as the Diabetic Foot Australia, is leading the cause for facilitating further amputation reductions via the improvement of system monitoring. With an integrated team of experts from various disciplines, their efforts will in time achieve their target objectives. They aim to eliminate amputations within a generation. 

How can you help? 

If you’re a diabetic, or a relative of a diabetic, enquire about their level of care. If there is a gap in the attention being paid to the patient, seek entities that will provide the services offered by entities such as Diabetic Foot Australia. You may save their lives via this action. 

Reference Article: 

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Pathway to ending avoidable diabetes-related amputations in Australia

Article in The Medical journal of Australia · September 2018

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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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