Outcomes after Total Ankle Arthroplasty with A Minimum Average Follow-Up of 10 Years: A Systematic Review and Meta-Analysis

Category: Ankle Arthritis Introduction/Purpose: End-stage ankle osteoarthritis (OA) is a debilitating condition that adversely affects quality of life and causes considerable functional impairment. Total ankle arthroplasty (TAA) is growing in popularity as a motion-preserving option for ankle OA. A...

Full description

Saved in:
Bibliographic Details
Published inFoot & ankle orthopaedics Vol. 8; no. 4
Main Authors Bagheri, Kian, Anastasio, Albert T., Cantor, Nicole, Aitchison, Alexandra Hunter, Poehlein, Emily, Green, Cynthia, Adams, Samuel
Format Journal Article
LanguageEnglish
Published Los Angeles, CA SAGE Publications 01.12.2023
Sage Publications Ltd
SAGE Publishing
Subjects
Online AccessGet full text

Cover

Loading…
Abstract Category: Ankle Arthritis Introduction/Purpose: End-stage ankle osteoarthritis (OA) is a debilitating condition that adversely affects quality of life and causes considerable functional impairment. Total ankle arthroplasty (TAA) is growing in popularity as a motion-preserving option for ankle OA. A previously published meta-analysis evaluated the mid-term outcomes of TAA with a minimum average follow-up of 5 years, demonstrating excellent survivorship. To our knowledge, there is no such manuscript that evaluates the outcomes of TAA at the long-term, with a minimum follow-up of ten years or greater. Due to a lack of long-term follow-up of TAA implants in the current literature, the aim of this review was to aggregate findings from the most up-to-date analyses of the long-term outcomes of TAA via meta-analysis. Methods: We conducted a systematic review and meta-analysis according to the PRISMA guidelines. Electronic databases were searched from the date of inception to September 12, 2022. These databases included Medline, Embase, and Scopus. We included all studies that 1) involved patients that underwent uncemented TAA, and 2) all patients who had an average follow-up period of at least ten years. We excluded abstracts, as well as manuscripts written in languages other than English. We collected American Orthopaedic Foot and Ankle Score (AOFAS) and Visual Analog Scale (VAS) scores from the included studies for pooled meta- analysis. Due to the varying definition of survivability between studies, this metric was not assessed in our final evaluation. Results: Our data included a total of 2,562 patients and 2,895 ankles with an average follow-up of 10 years. Of the 25 studies included in the systematic review, 7 provided pre- and post-operative AOFAS means and 5 provided pre- and post-operative VAS means with associated measures of variability and were included in our meta-analysis. The weighted mean difference between pre- and post-operative AOFAS scores was -41.98 (95% CI: -48.28 to -35.69) (Fig. 1A), indicating that patients improved by almost 42 points between pre-and post-surgery. The weighted mean difference between pre-and postoperative VAS scores was 4.52 (95% CI: 2.26-6.43) (Fig. 1B), indicating patients improved by about 4.5 points on average between pre-and post-surgery. Survivability was not assessed due to the heterogeneity in survivability definition between studies. Conclusion: Outcomes following TAA are favorable and indicate patient-reported outcomes improve over long-term follow-up. Future, prospective, randomized research should be conducted to better assess TAA, and authors should work towards standardization of survivorship and complication reporting methodologies to allow for pooled metanalysis of these important outcome metrics.
AbstractList Category: Ankle Arthritis Introduction/Purpose: End-stage ankle osteoarthritis (OA) is a debilitating condition that adversely affects quality of life and causes considerable functional impairment. Total ankle arthroplasty (TAA) is growing in popularity as a motion-preserving option for ankle OA. A previously published meta-analysis evaluated the mid-term outcomes of TAA with a minimum average follow-up of 5 years, demonstrating excellent survivorship. To our knowledge, there is no such manuscript that evaluates the outcomes of TAA at the long-term, with a minimum follow-up of ten years or greater. Due to a lack of long-term follow-up of TAA implants in the current literature, the aim of this review was to aggregate findings from the most up-to-date analyses of the long-term outcomes of TAA via meta-analysis. Methods: We conducted a systematic review and meta-analysis according to the PRISMA guidelines. Electronic databases were searched from the date of inception to September 12, 2022. These databases included Medline, Embase, and Scopus. We included all studies that 1) involved patients that underwent uncemented TAA, and 2) all patients who had an average follow-up period of at least ten years. We excluded abstracts, as well as manuscripts written in languages other than English. We collected American Orthopaedic Foot and Ankle Score (AOFAS) and Visual Analog Scale (VAS) scores from the included studies for pooled meta- analysis. Due to the varying definition of survivability between studies, this metric was not assessed in our final evaluation. Results: Our data included a total of 2,562 patients and 2,895 ankles with an average follow-up of 10 years. Of the 25 studies included in the systematic review, 7 provided pre- and post-operative AOFAS means and 5 provided pre- and post-operative VAS means with associated measures of variability and were included in our meta-analysis. The weighted mean difference between pre- and post-operative AOFAS scores was -41.98 (95% CI: -48.28 to -35.69) (Fig. 1A), indicating that patients improved by almost 42 points between pre-and post-surgery. The weighted mean difference between pre-and postoperative VAS scores was 4.52 (95% CI: 2.26-6.43) (Fig. 1B), indicating patients improved by about 4.5 points on average between pre-and post-surgery. Survivability was not assessed due to the heterogeneity in survivability definition between studies. Conclusion: Outcomes following TAA are favorable and indicate patient-reported outcomes improve over long-term follow-up. Future, prospective, randomized research should be conducted to better assess TAA, and authors should work towards standardization of survivorship and complication reporting methodologies to allow for pooled metanalysis of these important outcome metrics.
Category: Ankle Arthritis Introduction/Purpose: End-stage ankle osteoarthritis (OA) is a debilitating condition that adversely affects quality of life and causes considerable functional impairment. Total ankle arthroplasty (TAA) is growing in popularity as a motion-preserving option for ankle OA. A previously published meta-analysis evaluated the mid-term outcomes of TAA with a minimum average follow-up of 5 years, demonstrating excellent survivorship. To our knowledge, there is no such manuscript that evaluates the outcomes of TAA at the long-term, with a minimum follow-up of ten years or greater. Due to a lack of long-term follow-up of TAA implants in the current literature, the aim of this review was to aggregate findings from the most up-to-date analyses of the long-term outcomes of TAA via meta-analysis. Methods: We conducted a systematic review and meta-analysis according to the PRISMA guidelines. Electronic databases were searched from the date of inception to September 12, 2022. These databases included Medline, Embase, and Scopus. We included all studies that 1) involved patients that underwent uncemented TAA, and 2) all patients who had an average follow-up period of at least ten years. We excluded abstracts, as well as manuscripts written in languages other than English. We collected American Orthopaedic Foot and Ankle Score (AOFAS) and Visual Analog Scale (VAS) scores from the included studies for pooled meta- analysis. Due to the varying definition of survivability between studies, this metric was not assessed in our final evaluation. Results: Our data included a total of 2,562 patients and 2,895 ankles with an average follow-up of 10 years. Of the 25 studies included in the systematic review, 7 provided pre- and post-operative AOFAS means and 5 provided pre- and post-operative VAS means with associated measures of variability and were included in our meta-analysis. The weighted mean difference between pre- and post-operative AOFAS scores was -41.98 (95% CI: -48.28 to -35.69) (Fig. 1A), indicating that patients improved by almost 42 points between pre-and post-surgery. The weighted mean difference between pre-and postoperative VAS scores was 4.52 (95% CI: 2.26-6.43) (Fig. 1B), indicating patients improved by about 4.5 points on average between pre-and post-surgery. Survivability was not assessed due to the heterogeneity in survivability definition between studies. Conclusion: Outcomes following TAA are favorable and indicate patient-reported outcomes improve over long-term follow-up. Future, prospective, randomized research should be conducted to better assess TAA, and authors should work towards standardization of survivorship and complication reporting methodologies to allow for pooled metanalysis of these important outcome metrics.
Author Anastasio, Albert T.
Poehlein, Emily
Green, Cynthia
Bagheri, Kian
Aitchison, Alexandra Hunter
Adams, Samuel
Cantor, Nicole
Author_xml – sequence: 1
  givenname: Kian
  surname: Bagheri
  fullname: Bagheri, Kian
– sequence: 2
  givenname: Albert T.
  surname: Anastasio
  fullname: Anastasio, Albert T.
– sequence: 3
  givenname: Nicole
  surname: Cantor
  fullname: Cantor, Nicole
– sequence: 4
  givenname: Alexandra Hunter
  surname: Aitchison
  fullname: Aitchison, Alexandra Hunter
– sequence: 5
  givenname: Emily
  surname: Poehlein
  fullname: Poehlein, Emily
– sequence: 6
  givenname: Cynthia
  surname: Green
  fullname: Green, Cynthia
– sequence: 7
  givenname: Samuel
  surname: Adams
  fullname: Adams, Samuel
BookMark eNp1kUFv1DAQRiNUJErpnaMlzoEZx4kdLiiqKFRqVYm2B07WJJnsZknixfbuasWfJ8tWQJE42fr85tny9zI5mdzESfIa4S2i1u-k0hkgKpndAUAOz5LTQ5QespO_9i-S8xBWM4I6L0tjTpMft5vYuJGDoC6yF_cu0iCq6dvAovJx6d16oBD3YtfHpajETT_142YU1ZY9LVhcumFwu_RhLVwnEMRXJh_ez-DdPkQeKfaN-MLbnneCplbccKS0mmjYhz68Sp53NAQ-f1zPkofLj_cXn9Pr209XF9V12kiNkJat0dhmBStDKscMJLHu8to0NYHSWkmqqW5zleWyYdNgXbZFB5BBowwbk50lV0dv62hl174fye-to97-CpxfWPLzQwe2qsOypFZiV3QKuajRmFrV2AIzAvHs-nB0rTf1yG3DU_Q0PJE-PZn6pV24rUXQyhSoZ8ObR4N33zccol25jZ-_JFhZSpASc1XMFBypxrsQPHe_r0Cwh87tv53PI-lxJMzF_JH-l_8JkBKtMA
ContentType Journal Article
Copyright The Author(s) 2023
The Author(s) 2023. This work is licensed under the Creative Commons Attribution – Non-Commercial License https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
The Author(s) 2023 2023 American Orthopaedic Foot & Ankle Society, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses.
Copyright_xml – notice: The Author(s) 2023
– notice: The Author(s) 2023. This work is licensed under the Creative Commons Attribution – Non-Commercial License https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
– notice: The Author(s) 2023 2023 American Orthopaedic Foot & Ankle Society, unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses.
DBID AFRWT
AAYXX
CITATION
3V.
7RV
7X7
7XB
8FI
8FJ
8FK
ABUWG
AFKRA
AZQEC
BENPR
CCPQU
DWQXO
FYUFA
GHDGH
K9.
KB0
M0S
NAPCQ
PIMPY
PQEST
PQQKQ
PQUKI
PRINS
5PM
DOA
DOI 10.1177/2473011423S00050
DatabaseName Sage Journals GOLD Open Access 2024
CrossRef
ProQuest Central (Corporate)
ProQuest Nursing & Allied Health Database
Health & Medical Collection
ProQuest Central (purchase pre-March 2016)
Hospital Premium Collection
Hospital Premium Collection (Alumni Edition)
ProQuest Central (Alumni) (purchase pre-March 2016)
ProQuest Central (Alumni)
ProQuest Central
ProQuest Central Essentials
ProQuest Central
ProQuest One Community College
ProQuest Central Korea
Health Research Premium Collection
Health Research Premium Collection (Alumni)
ProQuest Health & Medical Complete (Alumni)
Nursing & Allied Health Database (Alumni Edition)
Health & Medical Collection (Alumni Edition)
Nursing & Allied Health Premium
Publicly Available Content Database
ProQuest One Academic Eastern Edition (DO NOT USE)
ProQuest One Academic
ProQuest One Academic UKI Edition
ProQuest Central China
PubMed Central (Full Participant titles)
Directory of Open Access Journals
DatabaseTitle CrossRef
Publicly Available Content Database
ProQuest Central Essentials
ProQuest One Academic Eastern Edition
ProQuest Health & Medical Complete (Alumni)
ProQuest Central (Alumni Edition)
ProQuest One Community College
ProQuest Nursing & Allied Health Source
ProQuest Hospital Collection
Health Research Premium Collection (Alumni)
ProQuest Central China
ProQuest Hospital Collection (Alumni)
ProQuest Central
Nursing & Allied Health Premium
ProQuest Health & Medical Complete
Health Research Premium Collection
ProQuest One Academic UKI Edition
Health and Medicine Complete (Alumni Edition)
ProQuest Central Korea
ProQuest Nursing & Allied Health Source (Alumni)
ProQuest One Academic
ProQuest Central (Alumni)
DatabaseTitleList
Publicly Available Content Database

Database_xml – sequence: 1
  dbid: DOA
  name: Open Access: DOAJ - Directory of Open Access Journals
  url: https://www.doaj.org/
  sourceTypes: Open Website
– sequence: 2
  dbid: AFRWT
  name: SAGE Open Access
  url: http://journals.sagepub.com/
  sourceTypes: Publisher
– sequence: 3
  dbid: 7X7
  name: ProQuest_Health & Medical Collection
  url: https://search.proquest.com/healthcomplete
  sourceTypes: Aggregation Database
DeliveryMethod fulltext_linktorsrc
EISSN 2473-0114
ExternalDocumentID oai_doaj_org_article_4f199ad21f6f41e6b188b4b1d0ee10ae
10_1177_2473011423S00050
10.1177_2473011423S00050
GroupedDBID 0R~
31X
54M
7RV
7X7
8FI
8FJ
AATBZ
ABQXT
ABUWG
ABVFX
ACARO
ACGFS
ACGZU
ACROE
ACSIQ
ADBBV
ADOGD
AEFTW
AEWDL
AEWHI
AFCOW
AFKRA
AFKRG
AFRWT
AIOMO
AJUZI
ALIPV
ALMA_UNASSIGNED_HOLDINGS
AUTPY
AYAKG
BCNDV
BDDNI
BENPR
BPHCQ
BSEHC
BVXVI
CCPQU
DC.
DV7
EBS
EIHBH
EJD
FYUFA
GROUPED_DOAJ
GROUPED_SAGE_PREMIER_JOURNAL_COLLECTION
H13
HMCUK
J8X
K.F
M~E
NAPCQ
O9-
OK1
PGMZT
PIMPY
PQQKQ
ROL
RPM
SFC
SFK
SFT
SGV
SPP
UKHRP
AASGM
AAYXX
CITATION
3V.
7XB
8FK
AZQEC
DWQXO
K9.
PQEST
PQUKI
PRINS
5PM
ID FETCH-LOGICAL-c2710-9d871d36e48a451302ae7f5b8cba047742ababd54352ce8c1b9d6f0030c48e883
IEDL.DBID RPM
ISSN 2473-0114
IngestDate Tue Oct 22 15:08:55 EDT 2024
Tue Sep 17 21:29:05 EDT 2024
Thu Oct 10 21:14:29 EDT 2024
Fri Dec 06 07:22:36 EST 2024
Sun Sep 29 05:52:21 EDT 2024
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 4
Keywords Ankle Arthritis
Total Ankle Arthroplasty
Ankle Arthrodesis
Language English
License This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c2710-9d871d36e48a451302ae7f5b8cba047742ababd54352ce8c1b9d6f0030c48e883
OpenAccessLink https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748617/
PQID 2920221546
PQPubID 4451124
ParticipantIDs doaj_primary_oai_doaj_org_article_4f199ad21f6f41e6b188b4b1d0ee10ae
pubmedcentral_primary_oai_pubmedcentral_nih_gov_10748617
proquest_journals_2920221546
crossref_primary_10_1177_2473011423S00050
sage_journals_10_1177_2473011423S00050
PublicationCentury 2000
PublicationDate 20231200
PublicationDateYYYYMMDD 2023-12-01
PublicationDate_xml – month: 12
  year: 2023
  text: 20231200
PublicationDecade 2020
PublicationPlace Los Angeles, CA
PublicationPlace_xml – name: Los Angeles, CA
– name: Thousand Oaks
– name: Sage CA: Los Angeles, CA
PublicationTitle Foot & ankle orthopaedics
PublicationYear 2023
Publisher SAGE Publications
Sage Publications Ltd
SAGE Publishing
Publisher_xml – name: SAGE Publications
– name: Sage Publications Ltd
– name: SAGE Publishing
SSID ssj0001759988
Score 2.2910023
Snippet Category: Ankle Arthritis Introduction/Purpose: End-stage ankle osteoarthritis (OA) is a debilitating condition that adversely affects quality of life and...
Category: Ankle Arthritis Introduction/Purpose: End-stage ankle osteoarthritis (OA) is a debilitating condition that adversely affects quality of life and...
SourceID doaj
pubmedcentral
proquest
crossref
sage
SourceType Open Website
Open Access Repository
Aggregation Database
Publisher
SubjectTerms Ankle
Arthritis
Joint surgery
Meta-analysis
Systematic review
SummonAdditionalLinks – databaseName: Directory of Open Access Journals
  dbid: DOA
  link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3PS8MwFA7iyYsoKtZf5CCCh2CTpm3qbYpjCNODDuapJE2CQ-2G6xDxn_cl7eY6EC9eemhfmybfS_Mlef0eQqdOVctGsSRKRZZwzRXJEsuIVEAeUs116v_j7t8lvQG_HcbDpVRfLiaslgeuG-6CW5plUjNqE8upSRQVQnFFdWgMDaXxX9-QLU2m_OpKGsM8QvzsS14w7n0Z2MODFz1pjUNerr_FMVcjJJfCvPzI091Cmw1lxJ36VbfRmil30Nf9rAJnMVPss3zjx3HlbMqXV-MsXfID4MXVJ3YLrbiD-6Ny9DZ7wx1wXSgDdwH_8QcZTPDYYhriJ_D46SUYPiyknXG9b4BlqXHfVJLMBUx20aB783jdI00iBVIwYBAk0zAt0lFiuJA8dluV0qQ2VqJQMuRAAJlUUukYqBMrjCioynRiXf8vuDBCRHtovRyXZh9hEUbWSCBRKZWchSxLFEwhtYCju5EH6HzerPmk1svIaSMpvgpBgK5cuy_snNK1PwH45w3--V_4B-hojlredL9p7lJwMSAzPAmQaCHZKqx9pRw9e3ltF6IqgNgF6MyB_vPU3-px8B_1OEQbLpN9HSlzhNar95k5Br5TqRPv2t-Zj_rE
  priority: 102
  providerName: Directory of Open Access Journals
– databaseName: Health & Medical Collection
  dbid: 7X7
  link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3PT9swFLZYd9llAjG0jB_yASHtYBEnTuJwQQVRIaSyA1TqTpEd21s1SApNhRD_PO-5aUuQxiWH5CVx_J7tz--9fI-QQ2TVcnGimNaxY8IIzfLURUxpAA-ZESbz_3EPr9PLkbgaJ-PW4TZr0yqXc6KfqE1doo_8GKsqRbA-ifR0-sCwahRGV9sSGp_IZx7BUg72nI2ztY8lS2A3IdfRyeNIeIsGDHHjqU86q5En7e8gzfd5km-Svfz6M9gkX1vgSPsLTW-RDVttk5df8waab2fU1_qmt3WDMtW_O4uSWAIB0HHzTNHdSvt0OKkm9_N72gcDhnfQAVhB_cRGU1o7ykP6G-x-dgKCNyuCZ7qIHlBVGTq0jWJLGpNvZDS4uD2_ZG05BVZGgCNYbmBzZOLUCqlEggFLZTOXaFlqFQqAgZHSSpsEAFRUWllynZvU4SxQCmmljHdIr6or-51QGcbOKoBSGVcC9JKnGjaSRsIRbxQB-bns1mK6YM0oeEss_l4FATnDfl_JId-1P1E__ina4VMIx_NcmYi71AluU82l1EJzE1rLQ2UDsrfUWtEOwlmxNpmAyI4mOy_rXqkmfz3JNiaqSoB3ATlCpa-f-r_v-PFxE3bJF6xUv8iE2SO95nFu9wHPNPrAG-0rx6_xbg
  priority: 102
  providerName: ProQuest
– databaseName: Sage Journals GOLD Open Access 2024
  dbid: AFRWT
  link: http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV1Bi9QwFA7r7MWLKCpWV8lBBA9xmzRtUy8yisMijII7g-upJE3iDjrtstMii3_e99J2x64IXnpIX_ua5KX5kvfyPUKeI6uWT1LNjEk8k1YaVmReMG0APORW2jyc415-zE7W8sNZenZA6vEszNCCu1cYVgVfFH7WOLpxN_p4cDIeCxkME6DAaWAwedO127Lf7R6TamAJuqe7LXq2K4yHvGLj6bZb5FDkMFHNyOF88fnLar8rk6ew_ghp7EAFQx173-ZfaidzWaD8n-DUm1GWf4SKhdlrcZfcGWAnnfd2co8cuPo--fWpa6HibkdDpnC6alqUqb__cCiJCRQAW7dXFDdr6ZwuN_Vm223pHGoJOugCbKj5ydYXtPGUx_QrjJrdaxA8vaaHpr3vgera0qVrNRtJUB6Q9eL96t0JG5IxsEoACmGFhaWVTTInlZYpuju1y31qVGV0LAFECm20sSnAL1E5VXFT2MzjP6SSyimVPCSzuqndI0JVnHinAYjlXEsRiyIzsAy1Cq74oIzIy7FZy4uec6PkAy35zS6IyFts92s5ZMsOBc3lt3IYfKX0vCi0FdxnXnKXGa6UkYbb2DkeaxeRo7HXytEAS0zjJQAQySwiatKTE2XTO_XmPFB0Y5irAnAYkRfY6fu3_qsej_9X8Am5jRnv-4iaIzJrLzv3FHBRa54NxvwbSdgGpw
  priority: 102
  providerName: SAGE Publications
Title Outcomes after Total Ankle Arthroplasty with A Minimum Average Follow-Up of 10 Years: A Systematic Review and Meta-Analysis
URI https://journals.sagepub.com/doi/full/10.1177/2473011423S00050
https://www.proquest.com/docview/2920221546
https://pubmed.ncbi.nlm.nih.gov/PMC10748617
https://doaj.org/article/4f199ad21f6f41e6b188b4b1d0ee10ae
Volume 8
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Ba9swFBZtd9llbGxj3rqgwyjsoMaSZVneLS0NZZCutAnLTkaypDWssUPjMEr__J4Uu60Lu_Rig_1s2XpPvO9JT99D6Itn1XJJqojWiSPccE1y4RhRGsBDZrjJwj7uyZk4nfHv83S-g0S3FyYk7Zd6cVhdLw-rxVXIrVwty2GXJzY8nxz7JEIJrne4i3bB_z6K0cPMSpZCDCEf1iSHjAc7BuRwGQhPej4oUPX38OXT7MhHKV7B64xfo1ctXMSj7We9QTu2eovufmwaMBS7xqHCN57WjZep_lxbL-kLHwAmbm6xn2TFIzxZVIvlZolHYLbQBh6D7uu_ZLbCtcM0xr_A2tffQPDyntYZb9cMsKoMnthGkY685B2ajU-mx6ekLaJASgbogeQGQiKTCMul4qlfplQ2c6mWpVYxB_DHlFbapACbWGllSXVuhPNjv-TSSpm8R3tVXdkPCMs4cVYBgMqo4ixmudAQPhoJR_8gj9DXrluL1ZYro6AtnfhTFUToyPf7vZxnuQ4X6pvfRavrgjua58ow6oTj1ApNpdRcUxNbS2NlI7Tfaa1oh9668OW3GAAZLiIke5rsNda_A5YWqLU7y4rQgVf6w1v_9x8fn9_GJ_TS167f5sbso73mZmM_A8Jp9ADMep4N0IvR-OLnFM5HJ2fnF4MwXzAIxv4P5RL-Tw
link.rule.ids 230,314,727,780,784,864,885,2102,12056,21388,21966,27853,27924,27925,31719,33744,43310,43805,44945,45333,53791,53793
linkProvider National Library of Medicine
linkToHtml http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwfV3fb9MwELage4CXCQSIsAF-QEg8WIsTJ3F4QR1aVWAtiLXSeIrs2B4VLClrKoT457lz3ZVMgpc8JJcf9p3tz3eX7wh5gaxaLs0U0zp1TBihWZm7hCkN4KEwwhT-P-7JNB_Pxfvz7Dw43FYhrXI7J_qJ2rQ1-siPsKpSAuuTyN8sfzCsGoXR1VBC4zbZQ-b0bED2jk-mnz7vvCxFBvsJuYtPHiXC2zSgiDNPftJbjzxtfw9r3syU_Cvdy69Ao3tkP0BHOtzo-j65ZZsH5PfHdQcNsCvqq33TWduhTPPtu0VJLIIA-Lj7RdHhSod0smgWl-tLOgQThnfQEdhB-5PNl7R1lMf0C1j-6jUInl1TPNNN_ICqxtCJ7RTbEpk8JPPRyeztmIWCCqxOAEmw0sD2yKS5FVKJDEOWyhYu07LWKhYABBOllTYZQKiktrLmujS5w3mgFtJKmT4ig6Zt7GNCZZw6qwBMFVwJ0EyZa9hKGglHvFFE5NW2W6vlhjej4oFa_KYKInKM_X4th4zX_kR7dVGFAVQJx8tSmYS73Aluc82l1EJzE1vLY2UjcrjVWhWG4araGU1EZE-TvZf1rzSLr55mG1NVJQC8iLxEpe-e-q92PPn_Jzwnd8azyWl1-m764YDcxbr1m7yYQzLortb2KaCbTj8LJvwHb6b1xA
linkToPdf http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3BbtQwELVKKyEuCFQQKQV8QEgc3MSOkzjclsKqFLZUalcqp8iO7XZF11l1s0KoP9-xN2mbSly45JBM4sTzEr-xJ28Qeu9VtWyaSaJUagnXXJEyt4xIBeSh0FwX4T_uyVF-MOWHZ9lZl1W57NIqXa1me-5yvudmFyG3cjGv4z5PLD6e7PskQgFDb7zQNn6EtrIUUHYvUg_zK0UGkYS4W5mMGQ9oBv5wEmRPBiNREOwfsMyHOZL3Er3C2DN-hp52pBGP1jf3HG0Yt42uf65agItZ4lDnG582rbdxvy-Nt_TlD4AZt3-xn2rFIzyZudl8NccjAC-0gceAgOYPmS5wYzFN8C_A_PITGJ7cijvj9coBlk7jiWkl6SVMXqDp-Ovp_gHpSimQmgGHIKWGwEinueFC8swvVkpT2EyJWsmEAwVkUkmlMyBPrDaipqrUufVfgJoLI0T6Em26xplXCIsktUYCjSqo5CxhZa4giNQCtv5EHqGPfbdWi7ViRkU7UfGHLojQZ9_vt3Ze6zrsaK7Oq87jFbe0LKVm1OaWU5MrKoTiiurEGJpIE6Hd3mtV9wIuK1-EiwGd4XmExMCTg8aGRwBvQWC7x1eEPnin3131X8-x8_9tvEOPj7-Mqx_fjr6_Rk98Mft1sswu2myvVuYNUJ5WvQ3YvgFNE_2a
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Outcomes+after+Total+Ankle+Arthroplasty+with+A+Minimum+Average+Follow-Up+of+10+Years%3A+A+Systematic+Review+and+Meta-Analysis&rft.jtitle=Foot+%26+ankle+orthopaedics&rft.au=Bagheri%2C+Kian&rft.au=Anastasio%2C+Albert+T.&rft.au=Cantor%2C+Nicole&rft.au=Aitchison%2C+Alexandra+Hunter&rft.date=2023-12-01&rft.pub=SAGE+Publications&rft.eissn=2473-0114&rft.volume=8&rft.issue=4&rft_id=info:doi/10.1177%2F2473011423S00050&rft.externalDBID=PMC10748617
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2473-0114&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2473-0114&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2473-0114&client=summon