Sport and physical activity after ankle arthrodesis with Ilizarov fixation and internal fixation

Background: Severe osteoarthritis (OA) of the ankle joint constitutes an important social problem.

Objectives: We used (1) the GRIMBY scale, (2) the LOWER LIMB Activity scale, (3) the UCLA (University of California Los Angeles) activity scale, (4) the VAS (visual analogue scale) ACTIVITY scale, and (5) the FAAM (foot and ankle ability measure) SPORT scale to verify whether the type of ankle joint arthrodesis stabilization affected sports and physical activity levels.

Material and methods: We carried out a prospective clinical study of 47 patients who had undergone ankle arthrodesis with Ilizarov external fixator stabilization (Group 1, n = 21) or internal stabilization with screws (Group 2, n = 26) at Orthopaedic Clinic at the Wroclaw Medical University, Poland, from 2007 to 2015. Sports and physical activity levels were measured by (1) the GRIMBY scale, (2) the LOWER LIMB Activity scale, (3) the UCLA activity scale, (4) the VAS ACTIVITY scale, and (5) the FAAM SPORT scale.

Results: A comparison between the average results of Group 1 and Group 2 on the LOWER LIMB Activity scale and the GRIMBY scale before and after surgery revealed no significant differences. In Group 1, the mean scores on the VAS ACTIVITY scale and the UCLA activity scale after treatment were higher than in Group 2. In Group 1, the mean outcome in the SPORT FAAM scale after treatment was 40; in Group 2 it was 30.06.

Conclusions: Ilizarov fixation of ankle arthrodesis is associated with better scores on the FAAM SPORT, UCLA activity and VAS ACTIVITY scales after treatment than internal fixation. The scores on the GRIMBY scale and the UCLA activity scale were significantly higher after treatment than before treatment in both groups. In this study, ankle fusion with Ilizarov fixation and internal fixation was found to be effective in the treatment of ankle arthritis. The levels of sport and physical activity were satisfactory in both groups, but the outcomes after fixation with the Ilizarov apparatus were better than after internal stabilization.