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Abstract
Total ankle replacement has been performed for treatment of end stage arthritis of the ankle, hopefully being an alternative to ankle arthrodesis. However, due to its high failure rates, earlier versions of ankle replacements were not regarded as successful procedures. The latest design has shown increasingly positive results. Total joint replacement of the ankle itself is still regarded as a demanding procedure and much more challenging than that of the hip and knee in many aspects. Several studies, however, have pointed out that it is becoming the viable, accepted alternative for arthrodesis with advanced implants, appropriate patient selection, and proper training experience of procedures. Compared with arthrodesis, it shows equal or better outcomes in pain relief, range of motion, and patient’s satisfaction. We are attempting to review its biomechanical characteristics, implant design, indications, complications, clinical outcomes, and survival rate.
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Figure 1.
These are preoperative anteroposterior (A) and lateral (B) radiographs of a 32-year-old woman with rheumatoid arthritis on the left ankle showing severe joint space narrowing, osteophyte, cystic change, and congruency loss of the ankle. These are anteroposterior (C) and lateral (D) radiographs of the left ankle four years after total ankle arthroplasty. It shows well positioned implant and improvement of alignment.
Figure 2.
These are preoperative anteroposterior (A) and lateral (B) radiographs of a 64-year-old woman with end stage arthritis showing severe joint space narrowing and loss of congruency with severe varus deformity of the right ankle, and flatfoot. These are anteroposterior (C) and lateral (D) radiographs at 8 years following operation, showing well positioned implant and improvement of alignment.
Figure 3.
These are preoperative anteroposterior (A) and lateral (B) radiographs of a 59-year-old woman with end stage arthritis and equinovarus deformity showing anterior subluxation and severe joint space narrowing of the right ankle, and flexion position of the first metatarsal. Four years following total ankle arthroplasty, anteroposterior (C) and lateral (D) radiographs show unchanged α, β, and g angles. However, osteolytic and cystic changes appeared above the tibial component.
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