Uncemented total ankle arthroplasty in post-traumatic osteoarthritis: 3- to 7-year follow-up

Abstract

Ankle replacement in post-traumatic arthritis is a challenging procedure, and adequate data are lacking about its results, as most studies are mainly focused on the results of ankle arthroplasty in primary osteoarthritis and rheumatoid arthritis. We present the results of 7 ankle replacements in posttraumatic arthritis with an uncemented total ankle arthroplasty at an average follow-up of 5.1 years (range, 3–7). One ankle had been revised and one ankle showed an unsatisfactory result (with radiographic signs of loosening of the talar component). The average functional score of the 6 surviving prostheses was 68.3 according to Kofoed and 70.8 according to AOFAS. Range of motion averaged 24.1° at follow-up. No infections nor collapse of the talus occurred. No ankles showed areas of periprosthetic osteolysis. Periarticular calcifications were a common finding (3 patients) but not evidently connected to the clinical result.

Radiographic signs of progressive degeneration of the neighboring joints were present in three patients at the talonavicular joint and in one patient at the talocalcaneal joint. Ankle arthroplasty with new generation prostheses is a promising procedure but results are still worse than those of replacement of the other major joints of the lower limb. Replacement of the post-traumatic ankle presents particular difficulties and studies should evaluate the results separately from ankles affected by primary osteoarthritis and rheumatoid arthritis.