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Updated: Jul 5, 2025

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Prophylactic Muscle Free Flap for Total Ankle Arthroplasty With Vascular Risk Factors.

Sofia E Olsson1, Arman J Fijany2, Michael W Downey3

  • 1Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas.

Eplasty
|January 18, 2024
PubMed
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Total ankle arthroplasty (TAA) can be a viable option for high-risk patients with ankle arthritis. A prophylactic muscle free flap can mitigate vascular risks, enabling successful TAA outcomes.

Area of Science:

  • Orthopedic Surgery
  • Vascular Surgery
  • Reconstructive Surgery

Background:

  • Total ankle arthroplasty (TAA) is a joint-preserving treatment for ankle arthritis.
  • Poor peripheral blood flow is a significant contraindication for TAA.
  • Identifying strategies to manage high-risk patients is crucial for successful TAA.

Observation:

  • A 63-year-old male patient with posttraumatic ankle osteoarthritis presented with multiple vascular risk factors.
  • These risk factors included obesity, trauma history, tobacco use, chronic venous stasis, lymphedema, and hypertension.
  • The patient was deemed high-risk for TAA due to these comorbidities.

Findings:

  • The patient successfully underwent TAA followed by a prophylactic muscle free flap.
Keywords:
Free FlapMuscle FlapSoft Tissue ReconstructionTotal Ankle ArthroplastyVascular Risk Factors

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  • The muscle free flap procedure aimed to enhance peripheral blood flow and soft tissue integrity.
  • Postoperatively, the patient experienced complete pain relief and excellent ankle mobility.

    • Implications:

    • Prophylactic muscle free flaps may be a valuable technique to mitigate vascular risks in high-risk TAA candidates.
    • This approach could expand the eligibility for TAA in patients with compromised peripheral circulation.
    • Further research is warranted to validate the efficacy and safety of this combined surgical strategy.