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Primary and Revision Total Ankle Replacement pp 223–230Cite as

Management of Painful Malleolar Gutters After Total Ankle Replacement

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Abstract

Total ankle replacement is a technically challenging procedure that has the potential to restore a pain-free, mobile, and stable ankle. Despite high satisfaction rates reported in the literature, patients complaining about malleolar gutter pain range from 2 to 23.5 % between various total ankle replacement prostheses and ankle arthritis etiologies. The exact cause has not been fully understood and appears to be multifactorial. However, recent literature reports that malleolar gutter pain is often a sign of overloading caused by malalignment of the hindfoot and the ankle or by malpositioning of the total ankle replacement components. Therefore, detailed clinical and radiographic assessment is essential to identify the incriminating factors provoking the malleolar gutter pain. These factors should always be addressed in association with debridement of the malleolar gutters in order to prevent recurrence of the patients’ symptoms. The present chapter explores the potential inciting factors of the gutter pain after total ankle replacement and how they can be managed.

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Author information

Authors and Affiliations

  1. Clinique du Parc Léopold, Foot and Ankle Institute, 38 Rue Froissart, Brussels, 1040, Belgium

    Bernhard Devos Bevernage MD, Paul-André Deleu MScPod & Thibaut Leemrijse MD

  2. Department of Orthopaedics, Pilgrim Hospital, Boston, PE21 9QS, UK

    Harish V. Kurup MBBS, MS, MRCSEd, PG Cert, FRCS

Authors
  1. Bernhard Devos Bevernage MD
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  2. Paul-André Deleu MScPod
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  3. Harish V. Kurup MBBS, MS, MRCSEd, PG Cert, FRCS
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  4. Thibaut Leemrijse MD
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Corresponding author

Correspondence to Harish V. Kurup MBBS, MS, MRCSEd, PG Cert, FRCS .

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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© 2016 Springer International Publishing Switzerland

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Bevernage, B.D., Deleu, PA., Kurup, H.V., Leemrijse, T. (2016). Management of Painful Malleolar Gutters After 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_20

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  • DOI: https://doi.org/10.1007/978-3-319-24415-0_20

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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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