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[The evolution of ankle arthroplasty].
1Orthopädische Klinik, Frederiksberg Hospital Kopenhagen, Denmark.
Der Orthopade
|October 20, 1999
Summary
Total ankle arthroplasty (TAA) outcomes can be improved by respecting anatomical, biomechanical, and biological features. Successful TAA requires meticulous surgery, proper alignment, and patient compliance for optimal, lasting results.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Biomaterials science
Context:
- Ankle arthroplasty results lag behind other joint replacements.
- Understanding ankle joint anatomy, kinesiology, and biomechanics is crucial for prosthesis design.
Purpose:
- To review the anatomical, kinesiological, biomechanical, and biological factors influencing ankle arthroplasty success.
- To establish guidelines for successful total ankle prosthesis design and patient selection.
Summary:
- Modern ankle arthroplasty must preserve normal anatomy and kinesiology.
- Prostheses should ensure cylindrical mobility, congruency, and normal torque, with cementless fixation in subchondral bone.
- Proper alignment, meticulous surgical technique, and postoperative rehabilitation are essential.
Impact:
- Adherence to these principles can reduce the average annual failure rate of ankle arthroplasty to below 1%.
- Defines key indications (osteoarthritis, rheumatoid arthritis) and contraindications (avascular necrosis, Charcot joint, severe systemic disease).
- Emphasizes patient selection and activity modification to ensure long-term implant survival and function.