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Osteoarthritis of the Ankle: The Role of Arthroplasty

Dr. Chou is Associate Professor, Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford University, Stanford, CA. Dr. Coughlin is Clinical Professor, Department of Orthopaedic Surgery and Rehabilitation, Oregon Health Sciences University, Portland, OR. Dr. Hansen is Professor, Department of Orthopaedic Surgery, University of Washington, Seattle, WA. Dr. Haskell is Orthopaedic Surgeon, Palo Alto Medical Foundation, Palo Alto, CA. Dr. Lundeen is Orthopaedic Surgeon, Reno Orthopedic Clinic, Reno, NV. Dr. Saltzman is Professor and Chair, Department of Orthopedics, University Orthopedic Center, University of Utah, Salt Lake City, UT. Dr. Mann is Associate Clinical Professor, Department of Orthopaedic Surgery, University of California School of Medicine, University of California, San Francisco, CA.

Dr. Coughlin or a member of his immediate family has received nonincome support (such as equipment or services), commercially derived honoraria, or other non-research–related funding (such as paid travel) from Link Orthopedics and is a consultant to or is an employee of Link Orthopedics. Dr. Hansen or a member of his immediate family serves as a consultant to or is an employee of DePuy. Dr. Saltzman or a member of his immediate family serves as a consultant to or is an employee of Link and Zimmer. Dr. Mann or a member of his immediate family serves as a consultant to or is an employee of Link Corporation. None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Chou, Dr. Haskell, and Dr. Lundeen.

This Symposium was presented at the AAOS 73rd Annual Meeting, Chicago, IL, March 22-26, 2006.

Total ankle arthroplasty was developed to reduce pain and retain motion of the ankle joint in patients with osteoarthritis. The ankle joint has unique, complex anatomic and biomechanical characteristics that must be considered in a successful total ankle arthroplasty prosthesis. Initial designs from the 1960s to the 1970s had many failures. Current designs use two or three components, and recent reports on total ankle arthroplasty show consistent good to excellent intermediate clinical results, with up to 90% decreased pain and high patient satisfaction. The follow-up time of these studies is limited, however, and long-term studies with 10- to 15-year follow-ups are needed. Also, a wide variety of complications has been reported, including osteomyelitis and osteolysis. To limit the number of complications and improve clinical outcome of total ankle arthroplasty, careful patient selection and surgeon experience are important.

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