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Abstract
Abstract. Introduction Total ankle replacement is definitely a tough issue for both orthopedic surgeons treating patients with ankle pathology and engineers who develop optimal implant constructs. Extreme short-time kinetic loads, complex motion biomechanics, anatomic features of the ankle result in high demands for ankle joint implants. In general, there is a positive tendency in an annual increase of the number of total ankle replacements. Alongside, a significant lagging in performing this procedure and the tendency for ankle arthrodesis has been observed in Russia. Aim To review the literature data about development and current status of total ankle replacement. To evaluate the use of modern implants for distal tibia replacement. Material and methods The given literature review includes analysis of foreign and domestic publications focused on issues of treatment of osteoarthritis of the ankle joint and tumors of the distal tibia. The information was searched for using GoogleScholar, PubMed, eLIBRARY, PubMedCentral in the Russian and English languages with the following keywords: total ankle replacement, ankle arthrodesis, ankle osteoarthritis, distal tibia replacement. Discussion Currently, there are controversies in selection of biomaterials and constructive parameters for ankle implants. Separately, there is an unsolved issue of selecting the optimal friction pair for bearing surfaces, as well as of operative technique features, such as implant fixation, surgical approach, modeling and restoration of the capsular-ligamentous complex. Conclusion Total ankle replacement is an effective alternative procedure to ankle arthrodesis and limb-sacrificing operations. To improve treatment results, optimal implant construction, fixation methods, selecting appropriate friction pair and capsular-ligamentous complex restoration should be further investigated in complex studies.
Highlights
Total ankle replacement is definitely a tough issue for both orthopedic surgeons treating patients with ankle pathology and engineers who develop optimal implant constructs
Our literature review analyzes foreign and domestic scientific publications dedicated to the treatment of osteoarthritis, tumor lesions of the ankle joint
Based on a review of the current literature, total ankle arthroplasty (TAA) is effective in treating pain and restoring function
Summary
Total ankle replacement is definitely a tough issue for both orthopedic surgeons treating patients with ankle pathology and engineers who develop optimal implant constructs. The general structure of the pathology of the distal tibia and ankle joint (AJ) consists of degenerative (arthrosis, arthritis of various etiologies, ankylosis) – 59 %, inflammatory (osteomyelitis of the leg and foot bones) – 7 %, hormonal (osteoporosis, secondary hyperparathyroidism) – 8 %, infectious (tuberculosis, alveococcosis) – 2 %, bone traumatic (consequences of injuries, fractures) – 22 % diseases. A separate group is patients with tumor lesions of the distal tibia and articular end (2 %) First of all, these are malignant neoplasms (osteosarcoma, chondrosarcoma, malignant chondroblastoma) – about 1 %, benign tumors (giant cell tumor, large chondromas causing significant destruction) – up to 3 %, secondary malignant neoplasms – 93 % and tumor-like diseases (bone marrow infarction, fibrous dysplasia) – no more than 3 % [2, 3]
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