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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure
Geert Pagenstert1, Beat Hintermann
1Department of Orthopaedic Surgery, University Clinics of Basel, Spitalstr, 21, CH-4031 Basel, Switzerland. gpagenstert@uhbs.ch
BMC Musculoskeletal Disorders
|October 15, 2011
Summary
Simultaneous quadruple total joint arthroplasty (TJA) for severe knee and ankle osteoarthritis offers improved outcomes. This single-anesthesia procedure led to faster recovery and better function compared to separate surgeries.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Rehabilitation Medicine
Background:
- Simultaneous osteoarthritis (OA) of the ankle complicates total knee arthroplasty (TKA) rehabilitation.
- Ankle arthritis can impede knee prosthetic component placement.
- Bilateral knee and ankle OA significantly impacts patient mobility and quality of life.
Observation:
- A 63-year-old patient with bilateral valgus/patellofemoral knee OA and bilateral varus ankle OA underwent simultaneous bilateral TKA and TAA (quadruple TJA).
- The procedure was performed during a single anesthesia session.
- Two-year follow-up demonstrated excellent alignment and function of all four replaced joints.
Findings:
- Quadruple TJA resulted in superior functional outcomes and accelerated recovery compared to literature averages for separate TKAs and TAAs.
- The patient returned to work in 6 weeks and had a 12-day hospital stay, markedly reduced from typical separate procedures.
- Excellent alignment and function were maintained in all four arthroplasty sites at two years post-surgery.
Implications:
- Simultaneous quadruple TJA is a viable option for patients with equally disabling bilateral knee and ankle OA.
- Careful preoperative planning, patient education, and dual surgical teams are crucial for successful outcomes.
- This approach may offer a more efficient treatment pathway, reducing overall recovery time and improving patient function.