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Updated: Aug 7, 2026
09:01
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
[Prosthetic replacement of the upper ankle joint]
1Zentrum für Knie- und Fusschirurgie, ATOS-Klinik, Bismarckstrasse 9-15, 69115 Heidelberg. thermann@atos.de
Der Unfallchirurg
|July 23, 2002
Summary
Early total ankle arthroplasty outcomes were poor due to design and fixation issues. Modern implants are improving, but patient selection and long-term results require further study.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
Context:
- Historical total ankle arthroplasty (TAA) in the 1970s-1980s showed poor outcomes.
- Failures were primarily due to constrained designs and cement fixation.
Purpose:
- To review the historical outcomes of TAA and compare them with current approaches.
- To identify factors influencing TAA success and failure.
Summary:
- Modern TAA employs unconstrained designs and uncemented fixation, addressing historical limitations.
- TAA remains technically demanding with potential complications; ideal patient selection is crucial.
- Osteonecrosis and osteoporosis negatively impact bony fixation and TAA success.
- Ankle fusion results also deteriorate over time, with peritarsal degeneration being common.
- Long-term outcomes of new TAA designs are currently unknown.
Impact:
- Highlights the evolution of TAA from poor historical results to current, albeit complex, procedures.
- Emphasizes the need for careful patient selection, including assessment of bone quality and ligamentous stability.
- Recommends limiting TAA to specialized centers for rigorous evaluation and clinical trials.
- Underscores ongoing efforts to develop reliable TAA solutions due to limitations of ankle fusion.
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