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Total ankle arthroplasty. Indications, techniques, and results
1University of North Carolina School of Medicine, Chapel Hill.
Orthopaedic Review
|April 1, 1994
Summary
Total ankle replacement is generally recommended for older rheumatoid arthritis patients with limited activity due to high complication rates. This surgical procedure requires specific techniques, and is not advised for younger patients with posttraumatic arthritis.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Total ankle replacement (TAR) has historically faced challenges with high complication and failure rates.
- Indications for TAR have been primarily limited to older patients with rheumatoid arthritis, particularly those with multiple joint issues and reduced mobility.
Purpose of the Study:
- To outline the recommended surgical techniques for total ankle arthroplasty.
- To provide guidance on patient selection for total ankle replacement based on existing literature.
Main Methods:
- Review of published studies and surgical technique recommendations for total ankle arthroplasty.
- Analysis of patient demographics and conditions associated with TAR outcomes.
Main Results:
- A high incidence of complications and failures has restricted the use of total ankle replacement.
- Specific surgical techniques, including patient positioning, anterior approach, bone resection, and cemented fixation, are crucial for successful TAR.
- Published data indicates that total ankle arthroplasty is not suitable for patients under 60 with posttraumatic arthritis.
Conclusions:
- Total ankle replacement demands meticulous surgical execution and careful patient selection.
- Contraindications for TAR include younger patients (under 60) with posttraumatic arthritis, emphasizing the need for alternative treatments for this demographic.