Total Ankle Replacement in Cavovarus Deformity: How Far Can We Go?

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Musculoskeletal research

Background:

• Total ankle replacement (TAR) is a viable alternative to ankle fusion, demonstrating good functional results and implant survival.
• Achieving proper alignment and balance is critical for the long-term success of total ankle replacement.
• Preoperative deformities can pose challenges to achieving optimal alignment and balance during TAR.

Purpose of the Study:

• To present a concept for staged total ankle replacement in patients with significant preoperative deformity.
• To illustrate a current surgical approach for total ankle replacement in the context of cavovarus deformity.
• To highlight the importance of deformity correction for successful total ankle replacement outcomes.

Main Methods:

• Review of the principles for staged surgical correction of lower extremity deformities.
• Description of a staged surgical technique involving initial deformity correction followed by total ankle replacement.
• Case illustration focusing on the application of this staged approach in patients with cavovarus foot deformity.

Main Results:

• The described staged procedure allows for satisfactory alignment and balance to be achieved in patients with significant preoperative deformities.
• This approach facilitates successful total ankle replacement in complex cases that might otherwise be contraindicated.
• Functional outcomes and implant survival are positively influenced by addressing deformities prior to arthroplasty.

Conclusions:

• Total ankle replacement is a successful procedure when meticulous attention is paid to achieving alignment and balance.
• A staged approach, including deformity correction, is a valuable strategy for managing complex cases requiring total ankle replacement.
• This concept provides a framework for optimizing outcomes in total ankle replacement for patients with significant preoperative deformities, such as cavovarus.