Abstract
Introduction. End-stage ankle osteoarthritis is a debilitating condition. Traditionally, ankle arthrodesis (AA) has been the surgical intervention of choice but the emergence of total ankle replacement (TAR) has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes. Methods. We conducted a systematic review according to PRISMA checklist using the online databases Medline and EMBASE after January 1, 2005. Participants must be skeletally mature and suffering from ankle arthrosis of any cause. The intervention had to be an uncemented TAR comprising two or three modular components. The comparative group could include any type of ankle arthrodesis, either open or arthroscopic, using any implant for fixation. The study must have reported at least one functional outcome measure. Results. Of the four studies included, two reported some significant improvement in functional outcome in favour of TAR. The complication rate was higher in the TAR group. However, the quality of studies reviewed was poor and the methodological weaknesses limited any definitive conclusions being drawn. Conclusion. The available literature is insufficient to conclude which treatment is superior. Further research is indicated and should be in the form of an adequately powered randomised controlled trial.
Highlights
End-stage ankle osteoarthritis is a debilitating condition that results in functional limitations and a poor quality of life [1]
The optimal study design when comparing two treatment modalities is a randomised controlled trial (RCT) as this allows for minimisation of bias
Two of the four studies reported statistically significant improvements in functional outcomes following total ankle replacement (TAR) [27, 29]; the other two studies showed no differences between the two groups [26, 28]
Summary
End-stage ankle osteoarthritis is a debilitating condition. Ankle arthrodesis (AA) has been the surgical intervention of choice but the emergence of total ankle replacement (TAR) has challenged this concept. This systematic review aims to address whether TAR or AA is optimal in terms of functional outcomes. Of the four studies included, two reported some significant improvement in functional outcome in favour of TAR. End-stage ankle osteoarthritis is a debilitating condition that results in functional limitations and a poor quality of life [1]. When surgical intervention is indicated, ankle arthrodesis (AA) has traditionally been used. The development of total ankle replacement (TAR) has challenged arthrodesis as the treatment of choice for ankle arthrosis [5,6,7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
