J Korean Foot Ankle Soc.  2018 Mar;22(1):8-15. 10.14193/jkfas.2018.22.1.8.

Severe Ankle Osteoarthritis: Treatment with Total Ankle Arthroplasty

• Jeong BO
• Jung H

• KMID: 2407369
• DOI: http://doi.org/10.14193/jkfas.2018.22.1.8

Abstract

Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

Keyword

Ankle; Osteoarthritis; Arthroplasty

MeSH Terms

Ankle Injuries
Ankle Joint
Ankle*
Arthritis
Arthroplasty*
Follow-Up Studies
Gait
Hip
Hip Joint
Joints
Knee
Osteoarthritis*
Survival Rate

Figure

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  Figure 1 (A) Medial malleolar fracture was detected in postoperative radiograph. (B) Open reduction and internal fixation was performed.

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  Figure 2 (A) Ankle osteoarthritis with distal tibial varus deformity. (B) Total ankle arthroplasty was performed following the correction of malalignment through supramalleolar osteotomy.

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  Figure 3 (A, B) Ankle osteoarthritis with talonavicular arthritis. (C, D) Total ankle arthroplasty was performed simultaneously with talonavicular arthrodesis.

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  Figure 4 (A) Abnormal position of polyethylene was detected because of the dislocation. (B) Modified Bröstrom procedure was performed after change to thicker polyethylene.

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