[Prosthesis implantation in the proximal ankle joint--a real therapeutic alternative in post-traumatic arthrosis?]

The results of total ankle arthroplasty were poor in the 1970s and 1980s compared to those of the arthrodeses. Because of the good long term results this technique has been accepted as the treatment of the choice for posttraumatic arthritis of the ankle. Recently the development of an unconstrained total ankle arthroplasty with an additional mobile polyethylene inlay between the fixed tibial and the talar component which enables a three dimensional range of motion seems to improve significantly the long term results of total ankle replacement. This technique, however, is an extremely demanding procedure. The range of motion after total ankle replacement following posttraumatic arthritis is poor compared to the results of total ankle replacement for rheumatoid arthritis. Furthermore, these data are obtained yet only by a few experienced surgeons in specialized centers. Further clinical trials have to be performed to answer the question whether the total ankle arthroplasty is a reliable alternative treatment of posttraumatic arthritis of the ankle. At present, the arthrodesis should be regarded as the treatment of choice for the posttraumatic arthritis of the ankle joint.