The painful total ankle arthroplasty: a diagnostic and treatment algorithm

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Reconstructive Surgery

Background:

• Total ankle arthroplasty (TAA) use has risen for end-stage knee arthritis.
• TAA implant longevity remains suboptimal compared to hip and knee arthroplasty.
• Painful TAA necessitates effective diagnostic and treatment strategies.

Purpose of the Study:

• To develop a diagnostic and treatment algorithm for painful TAA.
• To guide clinicians in managing TAA failure and considering revision surgery.
• To improve outcomes for patients experiencing TAA complications.

Main Methods:

• Systematic literature review of painful TAA cases.
• Analysis of diagnostic criteria for TAA failure.
• Evaluation of surgical and non-surgical treatment options for revision.

Main Results:

• Identified key indicators of TAA failure, including infection, loosening, and instability.
• Outlined a stepwise diagnostic approach involving clinical examination, imaging, and laboratory tests.
• Presented evidence-based treatment options ranging from non-operative management to complex revision procedures.

Conclusions:

• A structured algorithm can optimize the management of painful TAA.
• Timely diagnosis and appropriate treatment are crucial for successful TAA revision.
• Further research is needed to enhance TAA implant survival rates.