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Managing Soft-Tissue Ankle Equinus and Anterior/Posterior Translation of the Talus During Total Ankle Replacement

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Abstract

Soft-tissue ankle equinus and anterior–posterior translation of the talus are commonly encountered malalignment situations seen with end-stage ankle arthritis. These malalignments are important to recognize and correct at the time of primary total ankle replacement. The decision to perform a tendo-Achilles lengthening or a gastrocnemius-soleus lengthening is based mostly on surgeon preference and comfort level than evidence-based medicine. The management of anterior and posterior translation of the talus revolves primarily around tibial cut location/orientation, medial deltoid and posterior capsule soft-tissue release, medial and lateral gutter debridement, and lateral ligament reconstruction. Outcomes can be expected to be as good as of those ankles without talar translation in the sagittal plane, if the talus is reduced in all planes underneath the tibia.

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Author information

Authors and Affiliations

  1. Department of Trauma and Orthopaedics, Frimley Health NHS Foundation Trust, Frimley Park Hospital, Portsmouth Road, Frimley, GU16 7UJ, UK

    Nikolaos Gougoulias MD, PhD

  2. Department of Orthopedics, Hygeia Hospital, 21 Konossou St., Attika, 16674, Greece

    Thanos Badekas MD

  3. Department of Musculoskeletal Disorders, Faculty of Medicine, University of Salerno, Salerno, Italy

    Nicola Maffulli MD, MS, PhD, FRCP, FRCS(Orth)

  4. Queen Mary University of London, Barts and The London School of Medicine and Dentistry, William Harvey Research Institute, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, UK

    Nicola Maffulli MD, MS, PhD, FRCP, FRCS(Orth)

Authors
  1. Nikolaos Gougoulias MD, PhD
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  2. Thanos Badekas MD
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  3. Nicola Maffulli MD, MS, PhD, FRCP, FRCS(Orth)
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Corresponding author

Correspondence to Nikolaos Gougoulias MD, PhD .

Editor information

Editors and Affiliations

  1. Gundersen Health System, La Crosse, Wisconsin, USA

    Thomas S. Roukis

  2. Orthopedic Foot and Ankle Center, Westerville, Ohio, USA

    Gregory C. Berlet

  3. Wisconsin Foot and Ankle Institute, Marshfield, Wisconsin, USA

    Christopher Bibbo

  4. Orthopedic Foot and Ankle Center, Westerville, Ohio, USA

    Christopher F. Hyer

  5. Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada

    Murray J. Penner

  6. Foot and Ankle Center Karlsruhe, Karlsruhe, Germany

    Markus Wünschel

  7. Atlantic Foot & Ankle Center of Chesapeake, Chesapeake, Virginia, USA

    Mark A. Prissel

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Gougoulias, N., Badekas, T., Maffulli, N. (2016). Managing Soft-Tissue Ankle Equinus and Anterior/Posterior Translation of the Talus During Total Ankle Replacement. In: Roukis, T., et al. Primary and Revision Total Ankle Replacement. Springer, Cham. https://doi.org/10.1007/978-3-319-24415-0_15

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  • DOI: https://doi.org/10.1007/978-3-319-24415-0_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24413-6

  • Online ISBN: 978-3-319-24415-0

  • eBook Packages: MedicineMedicine (R0)

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