Functional outcome of routine versus on-demand removal of the syndesmotic screw a four-year follow-up

Stein van den Heuvel; Diederick Penning; Fay Sanders; Ruben van Veen; Nico Sosef; Bart van Dijkman; Tim Schepers; J. A. Halm; E. R. Flikweert; J. Hoogendoorn; N. W. L. Schep; J. Winkelhagen

doi:https://doi.org/10.1302/2633-1462.412.BJO-2023-0061

Functional outcome of routine versus on-demand removal of the syndesmotic screw a four-year follow-up

Stein van den Heuvel, Diederick Penning, Fay Sanders, Ruben van Veen, Nico Sosef, Bart van Dijkman, Tim Schepers, J. A. Halm, E. R. Flikweert, J. Hoogendoorn, N. W. L. Schep, J. Winkelhagen

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Aims The primary aim of this study was to present the mid-term follow-up of a multicentre randomized controlled trial (RCT) which compared the functional outcome following routine removal (RR) to the outcome following on-demand removal (ODR) of the syndesmotic screw (SS). Methods All patients included in the ‘ROutine vs on DEmand removal Of the syndesmotic screw’ (RODEO) trial received the Olerud-Molander Ankle Score (OMAS), American Orthopaedic Foot and Ankle Hindfoot Score (AOFAS), Foot and Ankle Outcome Score (FAOS), and EuroQol five-dimension questionnaire (EQ-5D). Out of the 152 patients, 109 (71.7%) completed the mid-term follow-up questionnaire and were included in this study (53 treated with RR and 56 with ODR). Median follow-up was 50 months (interquartile range 43.0 to 56.0) since the initial surgical treatment of the acute syndesmotic injury. The primary outcome of this study consisted of the OMAS scores of the two groups. Results The median OMAS score was 85.0 for patients treated with RR, and 90.0 for patients treated with ODR (p = 0.384), indicating no significant difference between ODR and RR. The secondary outcome measures included the AOFAS (88.0 in the RR group and 90.0 for ODR; p = 0.722), FAOS (87.5 in the RR group and 92.9 for ODR; p = 0.399), and EQ-5D (0.87 in the RR group and 0.96 for ODR; p = 0.092). Conclusion This study demonstrated no functional difference comparing ODR to RR in syndesmotic injuries at a four year follow-up period, which supports the results of the primary RODEO trial. ODR should be the standard practice after syndesmotic screw fixation.

Original language	English
Pages (from-to)	957-963
Number of pages	7
Journal	Bone and Joint Open
Volume	4
Issue number	12
DOIs	https://doi.org/10.1302/2633-1462.412.BJO-2023-0061
Publication status	Published - 1 Dec 2023

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van den Heuvel, S., Penning, D., Sanders, F., van Veen, R., Sosef, N., van Dijkman, B., Schepers, T., Halm, J. A., Flikweert, E. R., Hoogendoorn, J., Schep, N. W. L., & Winkelhagen, J. (2023). Functional outcome of routine versus on-demand removal of the syndesmotic screw a four-year follow-up. Bone and Joint Open, 4(12), 957-963. https://doi.org/10.1302/2633-1462.412.BJO-2023-0061

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title = "Functional outcome of routine versus on-demand removal of the syndesmotic screw a four-year follow-up",

abstract = "Aims The primary aim of this study was to present the mid-term follow-up of a multicentre randomized controlled trial (RCT) which compared the functional outcome following routine removal (RR) to the outcome following on-demand removal (ODR) of the syndesmotic screw (SS). Methods All patients included in the {\textquoteleft}ROutine vs on DEmand removal Of the syndesmotic screw{\textquoteright} (RODEO) trial received the Olerud-Molander Ankle Score (OMAS), American Orthopaedic Foot and Ankle Hindfoot Score (AOFAS), Foot and Ankle Outcome Score (FAOS), and EuroQol five-dimension questionnaire (EQ-5D). Out of the 152 patients, 109 (71.7%) completed the mid-term follow-up questionnaire and were included in this study (53 treated with RR and 56 with ODR). Median follow-up was 50 months (interquartile range 43.0 to 56.0) since the initial surgical treatment of the acute syndesmotic injury. The primary outcome of this study consisted of the OMAS scores of the two groups. Results The median OMAS score was 85.0 for patients treated with RR, and 90.0 for patients treated with ODR (p = 0.384), indicating no significant difference between ODR and RR. The secondary outcome measures included the AOFAS (88.0 in the RR group and 90.0 for ODR; p = 0.722), FAOS (87.5 in the RR group and 92.9 for ODR; p = 0.399), and EQ-5D (0.87 in the RR group and 0.96 for ODR; p = 0.092). Conclusion This study demonstrated no functional difference comparing ODR to RR in syndesmotic injuries at a four year follow-up period, which supports the results of the primary RODEO trial. ODR should be the standard practice after syndesmotic screw fixation.",

author = "{van den Heuvel}, Stein and Diederick Penning and Fay Sanders and {van Veen}, Ruben and Nico Sosef and {van Dijkman}, Bart and Tim Schepers and Halm, {J. A.} and Flikweert, {E. R.} and J. Hoogendoorn and Schep, {N. W. L.} and J. Winkelhagen",

note = "Funding Information: This trial was funded by ZonMw, a non-profit Dutch Government Institution, with project number 843002705. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Funding Information: The the open access fee was funded by ZonMw, a non-profit Dutch Government Institution, under project number 843002705. Publisher Copyright: {\textcopyright} 2023 Schepers et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https:// creativecommons.org/licenses/by-nc-nd/4.0/.",

year = "2023",

month = dec,

day = "1",

doi = "https://doi.org/10.1302/2633-1462.412.BJO-2023-0061",

language = "English",

volume = "4",

pages = "957--963",

journal = "Bone and Joint Open",

issn = "2633-1462",

publisher = "British Editorial Society of Bone and Joint Surgery",

number = "12",

}

van den Heuvel, S , Penning, D, Sanders, F, van Veen, R, Sosef, N, van Dijkman, B, Schepers, T , Halm, JA, Flikweert, ER, Hoogendoorn, J, Schep, NWL & Winkelhagen, J 2023, 'Functional outcome of routine versus on-demand removal of the syndesmotic screw a four-year follow-up', Bone and Joint Open, vol. 4, no. 12, pp. 957-963. https://doi.org/10.1302/2633-1462.412.BJO-2023-0061

TY - JOUR

T1 - Functional outcome of routine versus on-demand removal of the syndesmotic screw a four-year follow-up

AU - van den Heuvel, Stein

AU - Penning, Diederick

AU - Sanders, Fay

AU - van Veen, Ruben

AU - Sosef, Nico

AU - van Dijkman, Bart

AU - Schepers, Tim

AU - Halm, J. A.

AU - Flikweert, E. R.

AU - Hoogendoorn, J.

AU - Schep, N. W. L.

AU - Winkelhagen, J.

N1 - Funding Information: This trial was funded by ZonMw, a non-profit Dutch Government Institution, with project number 843002705. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. Funding Information: The the open access fee was funded by ZonMw, a non-profit Dutch Government Institution, under project number 843002705. Publisher Copyright: © 2023 Schepers et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https:// creativecommons.org/licenses/by-nc-nd/4.0/.

PY - 2023/12/1

Y1 - 2023/12/1

N2 - Aims The primary aim of this study was to present the mid-term follow-up of a multicentre randomized controlled trial (RCT) which compared the functional outcome following routine removal (RR) to the outcome following on-demand removal (ODR) of the syndesmotic screw (SS). Methods All patients included in the ‘ROutine vs on DEmand removal Of the syndesmotic screw’ (RODEO) trial received the Olerud-Molander Ankle Score (OMAS), American Orthopaedic Foot and Ankle Hindfoot Score (AOFAS), Foot and Ankle Outcome Score (FAOS), and EuroQol five-dimension questionnaire (EQ-5D). Out of the 152 patients, 109 (71.7%) completed the mid-term follow-up questionnaire and were included in this study (53 treated with RR and 56 with ODR). Median follow-up was 50 months (interquartile range 43.0 to 56.0) since the initial surgical treatment of the acute syndesmotic injury. The primary outcome of this study consisted of the OMAS scores of the two groups. Results The median OMAS score was 85.0 for patients treated with RR, and 90.0 for patients treated with ODR (p = 0.384), indicating no significant difference between ODR and RR. The secondary outcome measures included the AOFAS (88.0 in the RR group and 90.0 for ODR; p = 0.722), FAOS (87.5 in the RR group and 92.9 for ODR; p = 0.399), and EQ-5D (0.87 in the RR group and 0.96 for ODR; p = 0.092). Conclusion This study demonstrated no functional difference comparing ODR to RR in syndesmotic injuries at a four year follow-up period, which supports the results of the primary RODEO trial. ODR should be the standard practice after syndesmotic screw fixation.

AB - Aims The primary aim of this study was to present the mid-term follow-up of a multicentre randomized controlled trial (RCT) which compared the functional outcome following routine removal (RR) to the outcome following on-demand removal (ODR) of the syndesmotic screw (SS). Methods All patients included in the ‘ROutine vs on DEmand removal Of the syndesmotic screw’ (RODEO) trial received the Olerud-Molander Ankle Score (OMAS), American Orthopaedic Foot and Ankle Hindfoot Score (AOFAS), Foot and Ankle Outcome Score (FAOS), and EuroQol five-dimension questionnaire (EQ-5D). Out of the 152 patients, 109 (71.7%) completed the mid-term follow-up questionnaire and were included in this study (53 treated with RR and 56 with ODR). Median follow-up was 50 months (interquartile range 43.0 to 56.0) since the initial surgical treatment of the acute syndesmotic injury. The primary outcome of this study consisted of the OMAS scores of the two groups. Results The median OMAS score was 85.0 for patients treated with RR, and 90.0 for patients treated with ODR (p = 0.384), indicating no significant difference between ODR and RR. The secondary outcome measures included the AOFAS (88.0 in the RR group and 90.0 for ODR; p = 0.722), FAOS (87.5 in the RR group and 92.9 for ODR; p = 0.399), and EQ-5D (0.87 in the RR group and 0.96 for ODR; p = 0.092). Conclusion This study demonstrated no functional difference comparing ODR to RR in syndesmotic injuries at a four year follow-up period, which supports the results of the primary RODEO trial. ODR should be the standard practice after syndesmotic screw fixation.

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U2 - https://doi.org/10.1302/2633-1462.412.BJO-2023-0061

DO - https://doi.org/10.1302/2633-1462.412.BJO-2023-0061

M3 - Article

C2 - 38108322

SN - 2633-1462

VL - 4

SP - 957

EP - 963

JO - Bone and Joint Open

JF - Bone and Joint Open

IS - 12

ER -

Functional outcome of routine versus on-demand removal of the syndesmotic screw a four-year follow-up

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