Total Ankle Arthroplasty as Current Treatment for Ankle Arthritis

Abstract

Arthritis of the ankle can cause pain, joint incongruence, diminished motion, and functional disability. The traditional surgical treatment for ankle arthritis that has failed nonsurgical management is joint arthrodesis. However, ankle arthrodesis is not without shortcomings, which include the development of gait dysfunction and adjacent joint arthritis. Such problems promoted interest in total ankle arthroplasty (TAA) as early as the 1970s. In contrast to arthrodesis, TAA can have a wider variety of complications rather than ones that are worse. It is critical to view the shortcomings of modern TAA with a careful analysis of the literature. Several studies suggest that surgeon factors may play a role in certain complications. Other texts conclude that patient characteristics may be related to certain difficulties with TAA. These factors include age and pre-operative deformity. In an appropriate patient population, TAA performed by experienced surgeons reliably provides high clinical scores and satisfaction. Modern TAA is highly predictable in providing good to excellent clinical results that are as good, if not better, than ankle arthrodesis. TAA offers patients significantly improved function and decreased pain with high satisfaction rates. By conserving ankle motion, TAA approximates more of a normal gait pattern than arthrodesis. TAA also reliably decreases stresses on joints adjacent to the ankle such as the subtalar joint. For the right patient, ankle arthroplasty rather than arthrodesis is the better treatment option.