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Total ankle arthroplasty.

James K Deorio1, Mark E Easley

  • 1Duke Orthopaedics, Department of Orthopaedics, Duke University Medical Center, Durham, North Carolina, USA.

Instructional Course Lectures
|April 11, 2008
PubMed
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Total ankle arthroplasty (TAA) is a promising surgical option for advanced ankle arthritis, showing encouraging intermediate results. Careful patient selection and surgical experience are crucial for successful outcomes, though complications can be more frequent than with other joint replacements.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Ankle arthritis significantly impacts patient quality of life.
  • Ankle arthrodesis (fusion) has been the traditional treatment.
  • Total ankle arthroplasty (TAA) is emerging as a viable alternative.

Purpose of the Study:

  • To review the current status and evolution of total ankle arthroplasty (TAA).
  • To discuss indications, contraindications, and patient selection for TAA.
  • To evaluate various TAA prosthetic designs and their biomechanical advancements.

Main Methods:

  • Review of intermediate-term follow-up results for established TAA designs.
  • Analysis of innovative and biomechanically supported TAA systems.

Related Experiment Videos

  • Discussion of design modifications addressing concerns like edge loading.
  • Evaluation of advancements in surgical instrumentation for TAA.

    • Main Results:

    • Intermediate-term results for TAA are encouraging, supporting its use over arthrodesis in select patients.
    • Various TAA designs have evolved, with improvements in biomechanics and component articulation.
    • Recent designs address edge loading concerns through modifications to polyethylene and component surfaces.
    • Improved instrumentation has enhanced the practicality and safety of TAA implantation.

    Conclusions:

    • Total ankle arthroplasty (TAA) is an attractive surgical alternative for advanced ankle arthritis, particularly posttraumatic and inflammatory types.
    • Rigorous patient selection and surgeon experience are paramount for successful TAA outcomes.
    • While TAA shows promise, complications can be more frequent than with hip or knee arthroplasty, necessitating further long-term evaluation.