Partial Ankle Arthroplasty: Talus Resurfacing for Mild-to-Moderate Osteoarthritis and Talus Hemiarthroplasty for...

We present prospective short-term results of a limited patient series treated with two innovative partial ankle arthroplasties: talar dome resurfacing for mild-to-moderate ankle osteoarthritis and talar shoulder hemiarthroplasty for chronic medial osteochondral lesions of the talus.

Eleven patients underwent talus resurfacing and six patients had talar hemiarthroplasty. The outcome was followed by patient-reported measures and by pursuing serious adverse events or implant failures over a 2-year period. Progression of ankle osteoarthritis, peri-implant bone changes, and implant migration were followed radiographically.

Active dorsiflexion increased from 3° to 10° in resurfacing and from 15° to 22° in hemiarthroplasty. Patient-reported ankle function, quality of life, and activity level tended to improve only slightly after resurfacing (cumulative Foot and Ankle Outcome Score, from 41 to 42; Foot and Ankle Ability Measures for daily activities [FAAM-ADL], from 43 to 46; EQ-5D-3L time trade-off, from 0.38 to 0.39; Tegner activity scale score, from 1.6 to 2.0) but moderately after hemiarthroplasty (cumulative Foot and Ankle Outcome Score, from 58 to 68; FAAM-ADL, from 37 to 71; EQ-5D-3L time trade-off, from 0.53 to 0.72; Tegner activity scale score, from 3.1 to 3.1). No implant-related radiographic changes, implant failures, or implant-related revision surgeries were recorded.

Based on a small and heterogeneous prospective case series, both partial ankle implants investigated were safe and stable over 2-year follow-up, without any radiographic osteoarthritis progression of the remaining joint. However, patient-reported ankle function, quality of life, and activity level showed a tendency toward only minor improvement after resurfacing but a moderate increase after hemiarthroplasty.