Ankle arthroplasty alternatives with allograft and external fixation: preliminary clinical outcome

Tibiotalar joint reconstruction for the treatment of osteoarthritic and post-traumatic arthritic joint remains controversial and unsatisfactory. While the current literature recommends joint arthrodesis as a gold standard, current developments in allograft technology may aid in the repair of articular damage; avoid any metallic implant wear, failure, and revision; and preserve normal musculoskeletal biomechanics. The purpose of this retrospective study was to report the early clinical outcomes of ankle arthroplasty with allograft and with the application of a monolateral external fixation in the treatment of ankle arthritis. Eighteen patients (18 ankles, n = 18) with end-stage ankle arthritis, underwent surgical intervention. The mean preoperative AOFAS score was 32.0 +/- 1.1 (30-33) while the postop was 87.33 +/- 7.6 (81-97) (P = .000). There were no complications associated with the allograft material. There were also no complications with the external fixator. The early clinical outcome results provided an optimistic view of this procedure as another alternative treatment for the arthritic ankle, with subjective patient improvement and satisfaction, as well as a statistically significant and functionally increased range of motion and joint space and objective improvements. Allograft implantation with external fixation for the arthritic tibiotalar joint provided encouraging preliminary results and patient satisfaction mirroring current outcomes from shoulder and animal studies.

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