J Korean Med Assoc.  2013 Oct;56(10):908-914. 10.5124/jkma.2013.56.10.908.

Surgical treatments of the ankle arthritis

Affiliations
  • 1Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Korea. jungfoot@hanmail.net

Abstract

Trauma, such as ankle fractures, has been the major etiology of ankle arthritis. It has been reported that 70-80% of ankle arthritis cases are due to lateral ankle instability and post-traumatic ankle arthritis. Ankle arthrodesis is the gold standard for end-stage ankle arthritis treatment, but it restricts ankle motion and leads to adjacent joint arthritis in the long term. Low tibial osteotomy is indicated for unicompartmental ankle osteoarthritis (OA) with varus/valgus deformity to realign the malalignment and redistribute the localized tibial plafond and malleolar pressure upon the talus and relieve ankle pain. Ankle distraction arthroplasty is another option for young patients with early ankle OA to widen the ankle joint space and decrease pain. Total ankle arthroplasty (TAA) is a viable surgical alternative for end-stage ankle OA to relieve ankle pain while preserving ankle motion. Recently, a 3-component total ankle system has been predominant, and the outcomes and survival of TAA have improved somewhat. Prospective comparative studies on ankle arthrodesis and TAA should be performed in the future, especially with critical evaluation of complications. Ankle arthrodesis and TAA are 2 major surgical options for end-stage ankle arthritis, but research on other possible alternatives for early stage OA should be performed in the future.

Keyword

Ankle arthritis; Ankle arthrodesis; Low tibial osteotomy; Ankle distraction arthroplasty; Total ankle arthroplasty

MeSH Terms

Animals
Ankle
Ankle Joint
Arthritis
Arthrodesis
Arthroplasty
Congenital Abnormalities
Humans
Joints
Osteoarthritis
Osteotomy
Talus

Figure

  • Figure 1 Left ankle end-stage ankle osteoarthritis. (A) Preoperative X-ray and (B) after ankle arthrodesis.

  • Figure 2 Medial talo-malleolar ankle space has been widened after medial opening-wedge low tibial osteotomy. (A) Preoperative standing radiograph and (B,C) after low tibial osteotomy. Anteroposterior and lateral standing radiographs.

  • Figure 3 The tibio-talar joint space has been widened due to distraction with ring external fixator. (A) Preoperative X-ray and (B) after distraction arthrplasty.

  • Figure 4 Left ankle end-stage ankle osteoarthritis. (A) Preoperative ankle standing radiograph and (B) after total ankle arthroplasty performed.


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