Abstract
Ankle arthritis severely disables those it affects. Most commonly, it presents after ankle trauma, though instability, deformity, and inflammatory arthropathy are other common causes. Quality of life is affected to a degree similar to hip arthritis.1 A variety of surgical treatment options are available including ankle debridement, distraction arthroplasty, interposition arthroplasty, arthrodesis, allograft replacement, and total joint arthroplasty, each with its own limitations and benefits.2 Knowledge of these techniques allows the surgeon to tailor treatment of ankle arthritis based on patient needs, expected benefits, and risks.
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References
Glazebrook M, Daniels T, Younger A, et al. Comparison of health-related quality of life between patients with end-stage ankle and hip arthrosis. J Bone Joint Surg Am. 2008;90:499-505.
Chou LB, Coughlin MT, Hansen S Jr, et al. Osteoarthritis of the ankle: the role of arthroplasty. J Am Acad Orthop Surg. 2008;16:249-259.
Coester LM, Saltzman CL, Leupold J, Pontarelli W. Long-term results following ankle arthrodesis for post-traumatic arthritis. J Bone Joint Surg Am. 2001;83-A:219-228.
SooHoo NF, Kominski G. Cost-effectiveness analysis of total ankle arthroplasty. J Bone Joint Surg Am. 2004;86-A:2446-2455.
Cracchiolo A 3rd, Deorio JK. Design features of current total ankle replacements: implants and instrumentation. J Am Acad Orthop Surg. 2008;16:530-540.
Cerrato R, Myerson MS. Total ankle replacement: the Agility LP prosthesis. Foot Ankle Clin. 2008;13:485-494, ix.
Bonnin M, Judet T, Colombier JA, Buscayret F, Graveleau N, Piriou P. Midterm results of the Salto Total Ankle Prosthesis. Clin Orthop Relat Res. July 2004;(424):6-18.
Pyevich MT, Saltzman CL, Callaghan JJ, Alvine FG. Total ankle arthroplasty: a unique design. Two to twelve-year follow-up. J Bone Joint Surg Am. 1998;80:1410-1420.
Saltzman CL, Tochigi Y, Rudert MJ, McIff TE, Brown TD. The effect of agility ankle prosthesis misalignment on the peri-ankle ligaments. Clin Orthop Relat Res. July 2004;(424):137-142.
Leszko F, Komistek RD, Mahfouz MR, et al. In vivo kinematics of the salto total ankle prosthesis. Foot Ankle Int. 2008;29:1117-1125.
Conti S, Lalonde KA, Martin R. Kinematic analysis of the agility total ankle during gait. Foot Ankle Int. 2006;27:980-984.
Coetzee JC. Management of varus or valgus ankle deformity with ankle replacement. Foot Ankle Clin. 2008;13:509-520, x.
Haskell A, Mann RA, Ankle arthroplasty with preoperative coronal plane deformity: short-term results. Clin Orthop Relat Res. July 2004;(424):98-103.
Hennessy MS, Molloy AP, Wood EV. Management of the varus arthritic ankle. Foot Ankle Clin. 2008;13:417-442, viii.
Cornelis Doets H, van der Plaat LW, Klein JP. Medial malleolar osteotomy for the correction of varus deformity during total ankle arthroplasty: results in 15 ankles. Foot Ankle Int. 2008;29:171-177.
Bluman EM, Chiodo CP. Valgus ankle deformity and arthritis. Foot Ankle Clin. 2008;13:443-470, ix.
Tochigi Y, Rudert MJ, Brown TD, McIff TE, Saltzman CL. The effect of accuracy of implantation on range of movement of the Scandinavian total ankle replacement. J Bone Joint Surg Br. 2005;87:736-740.
McIff TE, Alvine FG, Saltzman CL, Klaren JC, Brown TD. Intraoperative measurement of distraction for ligament tensioning in total ankle arthroplasty. Clin Orthop Relat Res. July 2004;(424):111-117.
Knecht SI, Estin M, Callaghan JJ, et al. The Agility total ankle arthroplasty. Seven to sixteen-year follow-up. J Bone Joint Surg Am. 2004;86-A:1161-1171.
Coetzee JC, Pomeroy GC, Watts JD, Barrow C. The use of autologous concentrated growth factors to promote syndesmosis fusion in the Agility total ankle replacement. A preliminary study. Foot Ankle Int. 2005;26:840-846.
Barrow CR, Pomeroy GC. Enhancement of syndesmotic fusion rates in total ankle arthroplasty with the use of autologous platelet concentrate. Foot Ankle Int. 2005;26:458-461.
Adams SB Jr, Spritzer CE, Hofstaetter SG, et al. Computer-assisted tibia preparation for total ankle arthroplasty: a cadaveric study. Int J Med Robot. 2007;3:336-340.
Leardini A, Rapagna L, Ensini A, Catani F, Cappello A. Computer-assisted preoperative planning of a novel design of total ankle replacement. Comput Methods Programs Biomed. 2002;67:231-243.
Pena F, Agel J, Coetzee JC. Comparison of the MFA to the AOFAS outcome tool in a population undergoing total ankle replacement. Foot Ankle Int. 2007;28:788-793.
Kirkup J. Richard Smith ankle arthroplasty. J R Soc Med. 1985;78:301-304.
Bolton-Maggs BG, Sudlow RA, Freeman MA. Total ankle arthroplasty. A long-term review of the London Hospital experience. J Bone Joint Surg Br. 1985;67:785-790.
Jensen NC, Kroner K. Total ankle joint replacement: a clinical follow up. Orthopedics. 1992;15:236-239.
Unger AS, Inglis AE, Mow CS, Figgie HE 3rd. Total ankle arthroplasty in rheumatoid arthritis: a long-term follow-up study. Foot Ankle. 1988;8:173-179.
Kofoed H, Scandinavian Total Ankle Replacement (STAR). Clin Orthop Relat Res. July 2004;(424):73-79.
McGuire MR, Kyle RF, Gustilo RB, Premer RF. Comparative analysis of ankle arthroplasty versus ankle arthrodesis. Clin Orthop Relat Res. 1988;226:174-181.
Kitaoka HB, Patzer GL, Ilstrup DM, Wallrichs SL. Survivorship analysis of the Mayo total ankle arthroplasty. J Bone Joint Surg Am. 1994;76:974-979.
Kitaoka HB, Patzer GL. Clinical results of the Mayo total ankle arthroplasty. J Bone Joint Surg Am. 1996;78:1658-1664.
Buechel FF, Pappas MJ, Iorio LJ. New Jersey low contact stress total ankle replacement: biomechanical rationale and review of 23 cementless cases. Foot Ankle. 1988;8:279-290.
Kofoed H. Cylindrical cemented ankle arthroplasty: a prospective series with long-term follow-up. Foot Ankle Int. 1995;16:474-479.
Buechel FF, Pappas MJ. Survivorship and clinical evaluation of cementless, meniscal-bearing total ankle replacements. Semin Arthroplasty. 1992;3:43-50.
Alvine FG. Total ankle arthroplasty: new concepts and approaches. Contemp Orthop. 1991;22:397-403.
Wood PL, Prem H, Sutton C. Total ankle replacement: medium-term results in 200 Scandinavian total ankle replacements. J Bone Joint Surg Br. 2008;90:605-609.
Hurowitz EJ, Gould JS, Fleisig GS, Fowler R. Outcome analysis of agility total ankle replacement with prior adjunctive procedures: two to six year followup. Foot Ankle Int. 2007;28:308-312.
San Giovanni TP, Keblish DJ, Thomas WH, Wilson MG. Eight-year results of a minimally constrained total ankle arthroplasty. Foot Ankle Int. 2006;27:418-426.
Hosman AH, Mason RB, Hobbs T, Rothwell AG. A New Zealand national joint registry review of 202 total ankle replacements followed for up to 6 years. Acta Orthop. 2007;78:584-591.
Henricson A, Skoog A, Carlsson A. The Swedish ankle arthroplasty register: an analysis of 531 arthroplasties between 1993 and 2005. Acta Orthop. 2007;78:569-574.
Fevang BT, Lie SA, Havelin LI, Brun JG, Skredderstuen A, Furnes O. 257 ankle arthroplasties performed in Norway between 1994 and 2005. Acta Orthop. 2007;78:575-583.
Spirt AA, Assal M, Hansen ST Jr. Complications and failure after total ankle arthroplasty. J Bone Joint Surg Am. 2004;86-A:1172-1178.
Doets HC, Brand R, Nelissen RG. Total ankle arthroplasty in inflammatory joint disease with use of two mobile-bearing designs. J Bone Joint Surg Am. 2006;88:1272-1284.
Kofoed H, Sorensen TS. Ankle arthroplasty for rheumatoid arthritis and osteoarthritis: prospective long-term study of cemented replacements. J Bone Joint Surg Br. 1998;80:328-332.
Wood PL, Sutton C, Mishra V, Suneja R. A randomised, controlled trial of two mobile-bearing total ankle replacements. J Bone Joint Surg Br. 2009;91:69-74.
Kopp FJ, Patel MM, Deland JT, O’Malley MJ. Total ankle arthroplasty with the Agility prosthesis: clinical and radiographic evaluation. Foot Ankle Int. 2006;27:97-103.
Schutte BG, Louwerens JW. Short-term results of our first 49 Scandanavian total ankle replacements (STAR). Foot Ankle Int. 2008;29:124-127.
Anderson T, Montgomery F, Carlsson A. Uncemented STAR total ankle prostheses. J Bone Joint Surg Am. 2004;86-A(Suppl 1):103-111.
Anderson T, Montgomery F, Carlsson A. Uncemented STAR total ankle prostheses. Three to eight-year follow-up of fifty-one consecutive ankles. J Bone Joint Surg Am. 2003;85-A:1321-1329.
Valderrabano V, Pagenstert G, Horisberger M, Knupp M, Hintermann B. Sports and recreation activity of ankle arthritis patients before and after total ankle replacement. Am J Sports Med. 2006;34:993-999.
Saltzman CL, Mann RA, Coughlin MJ. Prospective controlled trial of STAR ankle replacement vs. ankle fusion: initial results. Annual Meeting of the American Academy of Orthopaedic Surgeons; 2009; Las Vegas.
Naal FD, Impellizzeri FM, Loibl M, Huber M, Rippstein PF. Habitual physical activity and sports participation after total ankle arthroplasty. Am J Sports Med. 2009;37:95-102.
Reggiani B, Leardini A, Corazza F, Taylor M. Finite element analysis of a total ankle replacement during the stance phase of gait. J Biomech. 2006;39:1435-1443.
Piriou P, Culpan P, Mullins M, Cardon JN, Pozzi D, Judet T. Ankle replacement versus arthrodesis: a comparative gait analysis study. Foot Ankle Int. 2008;29:3-9.
Valderrabano V, Nigg BM, von Tscharner V, Stefanyshyn DJ, Goepfert B, Hintermann B. Gait analysis in ankle osteoarthritis and total ankle replacement. Clin Biomech (Bristol, Avon). 2007;22:894-904.
Coetzee JC, Castro MD. Accurate measurement of ankle range of motion after total ankle arthroplasty. Clin Orthop Relat Res. July 2004;(424):27-31.
Muller S, Wolf S, Doderlein L. Three-dimensional analysis of the foot following implantation of a HINTEGRA ankle prosthesis: evaluation with the Heidelberg foot model. Orthopade. 2006;35:506-512.
Doets HC, van Middelkoop M, Houdijk H, Nelissen RG, Veeger HE. Gait analysis after successful mobile bearing total ankle replacement. Foot Ankle Int. 2007;28:313-322.
Michelson JD, Schmidt GR, Mizel MS. Kinematics of a total arthroplasty of the ankle: comparison to normal ankle motion. Foot Ankle Int. 2000;21:278-284.
Valderrabano V, Hintermann B, Nigg BM, Stefanyshyn D, Stergiou P. Kinematic changes after fusion and total replacement of the ankle: part 1: range of motion. Foot Ankle Int. 2003;24:881-887.
Valderrabano V, Hintermann B, Nigg BM, Stefanyshyn D, Stergiou P. Kinematic changes after fusion and total replacement of the ankle: part 2: movement transfer. Foot Ankle Int. 2003;24:888-896.
Valderrabano V, Hintermann B, Nigg BM, Stefanyshyn D, Stergiou P. Kinematic changes after fusion and total replacement of the ankle: part 3: talar movement. Foot Ankle Int. 2003;24:897-900.
Nicholson JJ, Parks BG, Stroud CC, Myerson MS. Joint contact characteristics in agility total ankle arthroplasty. Clin Orthop Relat Res. July 2004;(424):125-129.
Richter M, Zech S, Westphal R, Klimesch Y, Gosling T. Robotic cadaver testing of a new total ankle prosthesis model (German Ankle System). Foot Ankle Int. 2007;28:1276-1286.
Houdijk H, Doets HC, van Middelkoop M, Dirkjan Veeger HE. Joint stiffness of the ankle during walking after successful mobile-bearing total ankle replacement. Gait Posture. 2008;27:115-119.
Detrembleur C, Leemrijse T. The effects of total ankle replacement on gait disability: analysis of energetic and mechanical variables. Gait Posture. 2009;29(2):270-274.
Zerahn B, Kofoed H. Bone mineral density, gait analysis, and patient satisfaction, before and after ankle arthroplasty. Foot Ankle Int. 2004;25:208-214.
Zerahn B, Kofoed H, Borgwardt A. Increased bone mineral density adjacent to hydroxy-apatite-coated ankle arthroplasty. Foot Ankle Int. 2000;21:285-289.
Conti SF, Dazen D, Stewart G, et al. Proprioception after total ankle arthroplasty. Foot Ankle Int. 2008;29:1069-1073.
Valderrabano V, Nigg BM, von Tscharner V, Frank CB, Hintermann B. J. Leonard Goldner Award 2006. Total ankle replacement in ankle osteoarthritis: an analysis of muscle rehabilitation. Foot Ankle Int. 2007;28(281):291.
Valderrabano V, Hintermann B, von Tscharner V, Gopfert B, Dick W, Nigg BM. Muscle biomechanics in total ankle replacement. Orthopade. 2006;35:513-520.
Wood PL, Crawford LA, Suneja R, Kenyon A. Total ankle replacement for rheumatoid ankle arthritis. Foot Ankle Clin. 2007;12:497-508, vii.
Lachiewicz PF, Inglis AE, Ranawat CS. Total ankle replacement in rheumatoid arthritis. J Bone Joint Surg Am. 1984;66:340-343.
Helm R, Stevens J. Long-term results of total ankle replacement. J Arthroplasty. 1986;1:271-277.
Radossi P, Bisson R, Munari F, et al. Total ankle replacement for end-stage arthropathy in patients with haemophilia. Haemophilia. 2008;14:658-660.
Scholz R, Scholz U. The total ankle replacement for severe arthropathy in haemophilia. Hamostaseologie. 2008;28(Suppl 1):S40-S44.
van der Heide HJ, Novakova I, de Waal Malefijt MC. The feasibility of total ankle prosthesis for severe arthropathy in haemophilia and prothrombin deficiency. Haemophilia. 2006;12:679-682.
Davies MB, Saxby T. Ankle arthropathy of hemochromatosis: a case series and review of the literature. Foot Ankle Int. 2006;27:902-906.
Greisberg J, Assal M, Flueckiger G, Hansen ST, Jr. Takedown of ankle fusion and conversion to total ankle replacement. Clin Orthop Relat Res. July 2004;(424):80-88.
Hintermann B, Barg A, Knupp M, Valderrabano V. Conversion of painful ankle arthrodesis to total ankle arthroplasty. J Bone Joint Surg Am. 2009;91:850-858.
Liao X, Gao Z, Huang S, Yang S. Prevention and treatment of perioperative period complication of total ankle replacement. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008;22:40-43.
Schuberth JM, Patel S, Zarutsky E. Perioperative complications of the Agility total ankle replacement in 50 initial, consecutive cases. J Foot Ankle Surg. 2006;45:139-146.
Raikin SM, Myerson MS. Avoiding and managing complications of the Agility total ankle replacement system. Orthopedics. 2006;29:930-938.
Stamatis ED, Myerson MS. How to avoid specific complications of total ankle replacement. Foot Ankle Clin. 2002;7:765-789.
Conti SF, Wong YS. Complications of total ankle replacement. Foot Ankle Clin. 2002;7:791-807, vii.
Conti SF, Wong YS. Complications of total ankle replacement. Clin Orthop Relat Res. 2001;391:105-114.
SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg Am. 2007;89:2143-2149.
Saltzman CL, Amendola A, Anderson R, et al. Surgeon training and complications in total ankle arthroplasty. Foot Ankle Int. 2003;24:514-518.
Myerson MS, Mroczek K. Perioperative complications of total ankle arthroplasty. Foot Ankle Int. 2003;24:17-21.
Haskell A, Mann RA. Perioperative complication rate of total ankle replacement is reduced by surgeon experience. Foot Ankle Int. 2004;25:283-289.
Lee KB, Cho SG, Hur CI, Yoon TR. Perioperative complications of HINTEGRA total ankle replacement: our initial 50 cases. Foot Ankle Int. 2008;29:978-984.
Fukui A, Tanaka Y, Inada Y, et al. Turndown retinacular flap for closure of skin fistula after total ankle replacement. Foot Ankle Int. 2008;29:624-626.
Kotnis R, Pasapula C, Anwar F, Cooke PH, Sharp RJ. The management of failed ankle replacement. J Bone Joint Surg Br. 2006;88:1039-1047.
McGarvey WC, Clanton TO, Lunz D. Malleolar fracture after total ankle arthroplasty: a comparison of two designs. Clin Orthop Relat Res. July 2004;(424):104-110.
Tochigi Y, Suh JS, Amendola A, Pedersen DR, Saltzman CL. Ankle alignment on lateral radiographs. Part 1: sensitivity of measures to perturbations of ankle positioning. Foot Ankle Int. 2006;27:82-87.
Tochigi Y, Suh JS, Amendola A, Saltzman CL. Ankle alignment on lateral radiographs. Part 2: reliability and validity of measures. Foot Ankle Int. 2006;27:88-92.
Nelissen RG, Doets HC, Valstar ER. Early migration of the tibial component of the buechel-pappas total ankle prosthesis. Clin Orthop Relat Res. 2006;448:146-151.
Carlsson A, Markusson P, Sundberg M. Radiostereometric analysis of the double-coated STAR total ankle prosthesis: a 3–5 year follow-up of 5 cases with rheumatoid arthritis and 5 cases with osteoarthrosis. Acta Orthop. 2005;76:573-579.
Dahabreh Z, Gonsalves S, Monkhouse R, Harris NJ. Extrusion of metal radiological marker from a total ankle replacement insert: a case report. J Foot Ankle Surg. 2006;45:185-189.
Assal M, Al-Shaikh R, Reiber BH, Hansen ST. Fracture of the polyethylene component in an ankle arthroplasty: a case report. Foot Ankle Int. 2003;24:901-903.
Kobayashi A, Minoda Y, Kadoya Y, Ohashi H, Takaoka K, Saltzman CL. Ankle arthroplasties generate wear particles similar to knee arthroplasties. Clin Orthop Relat Res. July 2004;(424):69-72.
Affatato S, Leardini A, Leardini W, Giannini S, Viceconti M. Meniscal wear at a three-component total ankle prosthesis by a knee joint simulator. J Biomech. 2007;40:1871-1876.
Bell CJ, Fisher J. Simulation of polyethylene wear in ankle joint prostheses. J Biomed Mater Res B Appl Biomater. 2007;81:162-167.
Hanna RS, Haddad SL, Lazarus ML. Evaluation of periprosthetic lucency after total ankle arthroplasty: helical CT versus conventional radiography. Foot Ankle Int. 2007;28:921-926.
Kurup HV, Taylor GR. Medial impingement after ankle replacement. Int Orthop. 2008;32:243-246.
Bejjanki NK, Moulder E, Al-Nammari S, Budgen A. Tarsal tunnel syndrome as a complication of total ankle athroplasty: a case report. Foot Ankle Int. 2008;29:347-350.
Wapner KL. Salvage of failed and infected total ankle replacements with fusion. Instr Course Lect. 2002;51:153-157.
Myerson MS, Miller SD. Salvage after complications of total ankle arthroplasty. Foot Ankle Clin. 2002;7:191-206.
Thomason K, Eyres KS. A technique of fusion for failed total replacement of the ankle: tibio-allograft-calcaneal fusion with a locked retrograde intramedullary nail. J Bone Joint Surg Br. 2008;90:885-888.
Culpan P, Le Strat V, Piriou P, Judet T. Arthrodesis after failed total ankle replacement. J Bone Joint Surg Br. 2007;89:1178-1183.
Schill S. Ankle arthrodesis with interposition graft as a salvage procedure after failed total ankle replacement. Oper Orthop Traumatol. 2007;19:547-560.
Carlsson A. Unsuccessful use of a titanium mesh cage in ankle arthrodesis: a report on three cases operated on due to a failed ankle replacement. J Foot Ankle Surg. 2008;47:337-342.
Zarutsky E, Rush SM, Schuberth JM. The use of circular wire external fixation in the treatment of salvage ankle arthrodesis. J Foot Ankle Surg. 2005;44:22-31.
Carlsson AS, Montgomery F, Besjakov J. Arthrodesis of the ankle secondary to replacement. Foot Ankle Int. 1998;19:240-245.
Ritter M, Nickisch F, DiGiovanni C. Technique tip: posterior blade plate for salvage of failed total ankle arthroplasty. Foot Ankle Int. 2006;27:303-304.
Hopgood P, Kumar R, Wood PL. Ankle arthrodesis for failed total ankle replacement. J Bone Joint Surg Br. 2006;88:1032-1038.
Kitaoka HB, Romness DW. Arthrodesis for failed ankle arthroplasty. J Arthroplasty. 1992;7:277-284.
Gould JS. Revision total ankle arthroplasty. Am J Orthop. 2005;34:361.
Myerson MS, Won HY. Primary and revision total ankle replacement using custom-designed prostheses. Foot Ankle Clin. 2008;13:521-538, x.
Assal M, Greisberg J, Hansen ST Jr. Revision total ankle arthroplasty: conversion of New Jersey Low Contact Stress to Agility: surgical technique and case report. Foot Ankle Int. 2004;25:922-925.
DiDomenico LA, Williams K. Revisional total ankle arthroplasty because of a large tibial bone cyst. J Foot Ankle Surg. 2008;47:453-456.
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Haskell, A. (2012). Total Ankle Arthroplasty: The US Experience. In: Saxena, A. (eds) International Advances in Foot and Ankle Surgery. Springer, London. https://doi.org/10.1007/978-0-85729-609-2_43
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