Ankle arthritis: joint-preserving surgery and total ankle arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Yaxing ,  ZHANG Hui

Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;

Corresponding author：

ZHANG Hui, Email: footanklecenterwch@163.com

Keywords：

Ankle arthritis; ankle preservation; total ankle arthroplasty

DOI：

10.7507/1002-1892.202306039

Video：

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Abstract Full text Figures/Tables Video References Cited by

Ankle arthritis affects approximately 1% of the adult population worldwide and represents a serious global disease burden. However, compared with hip arthritis and knee arthritis, the clinical understanding and treatment of ankle arthritis are still in their infancy. For end-stage ankle arthritis, ankle arthrodesis was considered as the “gold standard” in the past. However, ankle arthrodesis will result in loss of joint mobility, altered gait, limited daily activities, and accelerated degeneration of adjacent joints. Therefore, how to preserve the range of motion of the ankle joint while relieving pain is the key to the treatment of ankle arthritis. Currently, the surgical treatment of ankle arthritis includes arthroscopic debridement, periarticular osteotomies, osteochondral transplantation, ankle distraction arthroplasty, ankle arthrodesis, and total ankle arthroplasty. The choice of treatment should be individualized and based on various factors such as the patient’s symptoms, signs, imaging performance, complaints, and financial situation. However, there are no guidelines that give clear treatment recommendations. Therefore, it is necessary to conduct extensive and in-depth discussions on the diagnosis and treatment of ankle arthritis.

Citation： LI Yaxing, ZHANG Hui. Ankle arthritis: joint-preserving surgery and total ankle arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(7): 769-775. doi: 10.7507/1002-1892.202306039 Copy

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8.	Saltzman CL, Zimmerman MB, O’Rourke M, et al. Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis. J Bone Joint Surg (Am), 2006, 88(11): 2366-2372.
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1. Barg A, Pagenstert GI, Hügle T, et al. Ankle osteoarthritis: etiology, diagnostics, and classification. Foot Ankle Clin, 2013, 18(3): 411-426.
2. Hayes BJ, Gonzalez T, Smith JT, et al. Ankle arthritis: you can’t always replace it. J Am Acad Orthop Surg, 2016, 24(2): e29-e38.
3. Bloch B, Srinivasan S, Mangwani J. Current concepts in the management of ankle osteoarthritis: a systematic review. J Foot Ankle Surg, 2015, 54(5): 932-939.
4. Valderrabano V. Joint-preserving surgery of ankle osteoarthritis. Foot Ankle Clin, 2013, 18(3): xiii-xiv. doi: 10.1016/j.fcl.2013.06.013.
5. DiDomenico LA, Anania MC. Total ankle replacements: an overview. Clin Podiatr Med Surg, 2011, 28(4): 727-744.
6. Glazebrook M, Daniels T, Younger A, et al. Comparison of health-related quality of life between patients with end-stage ankle and hip arthrosis. J Bone Joint Surg (Am), 2008, 90(3): 499-505.
7. Angthong C. Health-related quality of life and functional outcomes in ankle arthritis patients based on treating with and without total ankle replacement surgery. J Med Assoc Thai, 2015, 98 Suppl 2: S131-S137.
8. Saltzman CL, Zimmerman MB, O’Rourke M, et al. Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis. J Bone Joint Surg (Am), 2006, 88(11): 2366-2372.
9. Valderrabano V, Horisberger M, Russell I, et al. Etiology of ankle osteoarthritis. Clin Orthop Relat Res, 2009, 467(7): 1800-1806.
10. Herrera-Pérez M, Valderrabano V, Godoy-Santos AL, et al. Ankle osteoarthritis: comprehensive review and treatment algorithm proposal. EFORT Open Rev, 2022, 7(7): 448-459.
11. Horisberger M, Valderrabano V, Hintermann B. Posttraumatic ankle osteoarthritis after ankle-related fractures. J Orthop Trauma, 2009, 23(1): 60-67.
12. Saltzman CL, Salamon ML, Blanchard GM, et al. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J, 2005, 25: 44-46.
13. Herrera-Pérez M, González-Martín D, Vallejo-Márquez M, et al. Ankle Osteoarthritis Aetiology. J Clin Med, 2021, 10(19): 4489. doi: 10.3390/jcm10194489.
14. Takakura Y, Tanaka Y, Kumai T, Tamai S. Low tibial osteotomy for osteoarthritis of the ankle. Results of a new operation in 18 patients. J Bone Joint Surg (Br), 1995, 77(1): 50-54.
15. Tanaka Y, Takakura Y, Hayashi K, et al. Low tibial osteotomy for varus-type osteoarthritis of the ankle. J Bone Joint Surg (Br), 2006, 88(7): 909-913.
16. Hintermann B, Knupp M, Barg A. Supramalleolar osteotomies for the treatment of ankle arthritis. J Am Acad Orthop Surg, 2016, 24(7): 424-432.
17. DiDomenico LA, Gatalyak N. End-stage ankle arthritis: arthrodiastasis, supramalleolar osteotomy, or arthrodesis? Clin Podiatr Med Surg, 2012, 29(3): 391-412.
18. Goldberg AJ, Chowdhury K, Bordea E, et al. Total ankle replacement versus ankle arthrodesis for patients aged 50-85 years with end-stage ankle osteoarthritis: the TARVA RCT. Health Technol Assess, 2023, 27(5): 1-80.
19. Li X, Xu X. Joint Preservation for posttraumatic ankle arthritis after tibial plafond fracture. Foot Ankle Clin, 2022, 27(1): 73-90.
20. Alajlan A, Santini S, Alsayel F, et al. Joint-preserving surgery in varus ankle osteoarthritis. J Clin Med, 2022, 11(8): 2194. doi: 10.3390/jcm11082194.
21. Hintermann B, Ruiz R. Joint preservation strategies for managing varus ankle deformities. Foot Ankle Clin, 2022, 27(1): 37-56.
22. Wu Y, Yang H, Guo X, et al. Total ankle replacement with INBONE-Ⅱ prosthesis: A short-to- medium-term follow-up study in China. Chin Med J (Engl), 2022, 135(12): 1459-1465.
23. Xu Y, Xu XY. Medial open-wedge supramalleolar osteotomy for patients with takakura 3b ankle osteoarthritis: a mid- to long-term study. Biomed Res Int, 2019, 2019: 7630868. doi: 10.1155/2019/7630868.
24. Cody EA, Scott DJ, Easley ME. Total ankle arthroplasty: a critical analysis review. JBJS Rev, 2018, 6(8): e8. doi: 10.2106/JBJS.RVW.17.00182.
25. Krähenbühl N, Zwicky L, Bolliger L, et al. Mid- to long-term results of supramalleolar osteotomy. Foot Ankle Int, 2017, 38(2): 124-132.
26. Singer S, Klejman S, Pinsker E, et al. Ankle arthroplasty and ankle arthrodesis: gait analysis compared with normal controls. J Bone Joint Surg (Am), 2013, 95(24): e191(1-10).191-191.
27. Apostle KL, Sangeorzan BJ. Anatomy of the varus foot and ankle. Foot Ankle Clin, 2012, 17(1): 1-11.
28. Ahn TK, Yi Y, Cho JH, et al. A cohort study of patients undergoing distal tibial osteotomy without fibular osteotomy for medial ankle arthritis with mortise widening. J Bone Joint Surg (Am), 2015, 97(5): 381-388.
29. Kim JB, Yi Y, Kim JY, et al. Weight-bearing computed tomography findings in varus ankle osteoarthritis: abnormal internal rotation of the talus in the axial plane. Skeletal Radiol, 2017, 46(8): 1071-1080.
30. Becker AS, Myerson MS. The indications and technique of supramalleolar osteotomy. Foot Ankle Clin, 2009, 14(3): 549-561.
31. Haraguchi N. Analysis of whole limb alignment in ankle arthritis. Foot Ankle Clin, 2022, 27(1): 1-12.
32. Lintz F, Beaudet P, Richardi G, et al. Weight-bearing CT in foot and ankle pathology. Orthop Traumatol Surg Res, 2021, 107(1S): 102772. https://doi.org/10.1016/j.otsr.2020.102772.
33. Kang C, Lee GS, Kang DH, et al. The value of axial loading 3D CT as a substitute for full weightbearing 3D CT. Foot & Ankle Orthopaedics, 2018, 3(3): 2473011418S0027. doi: 10.1177/2473011418S00279.
34. 李亚星, 胡晓兵, 张晖, 等. 一种卧位负重CT模拟装置及方法: CN111685789B[P]. 2023-01-31.
35. 张志鹏, 魏超群. 一种CT检查下肢负重牵引器: CN213155962U[P]. 2021-05-11.
36. 邱小锋, 陈文明, 陈立, 等. 一种用于足部模拟负重CT时的足底压力采集装置: CN212037526U[P]. 2020-12-01.
37. 何飞, 钟宗雨, 张鹏. 一种CT扫描模拟负重装置: CN209048159U[P]. 2019-07-02.
38. Osti L, Del Buono A, Maffulli N. Arthroscopic debridement of the ankle for mild to moderate osteoarthritis: a midterm follow-up study in former professional soccer players. J Orthop Surg Res, 2016, 11: 37. doi: 10.1186/s13018-016-0368-z.
39. Assenmacher AT, Pareek A, Reardon PJ, et al. Long-term outcomes after osteochondral allograft: a systematic review at long-term follow-up of 12. 3 years. Arthroscopy, 2016, 32(10): 2160-2168.
40. Jeng CL, Kadakia A, White KL, et al. Fresh osteochondral total ankle allograft transplantation for the treatment of ankle arthritis. Foot Ankle Int, 2008, 29(6): 554-560.
41. Bugbee WD, Khanna G, Cavallo M, et al. Bipolar fresh osteochondral allografting of the tibiotalar joint. J Bone Joint Surg (Am), 2013, 95(5): 426-432.
42. Shimozono Y, Hurley ET, Nguyen JT, et al. Allograft compared with autograft in osteochondral transplantation for the treatment of osteochondral lesions of the talus. J Bone Joint Surg (Am), 2018, 100(21): 1838-1844.
43. Ng A, Bernhard A, Bernhard K. Advances in ankle cartilage repair. Clin Podiatr Med Surg, 2017, 34(4): 471-487.
44. Ng A, Bernhard K. Osteochondral autograft and allograft transplantation in the talus. Clin Podiatr Med Surg, 2017, 34(4): 461-469.
45. Liu X, An J, Zhang H, et al. Autologous osteochondral graft for early posttraumatic arthritis of tibiotalar joints after comminuted pilon fractures in young patients. Foot Ankle Int, 2020, 41(1): 69-78.
46. van Valburg AA, van Roermund PM, Marijnissen AC, et al. Joint distraction in treatment of osteoarthritis: a two-year follow-up of the ankle. Osteoarthritis Cartilage, 1999, 7(5): 474-479.
47. Cleary G, Pain C, McCann L, et al. Short-term outcome of surgical arthrodiastasis of the ankle with Ilizarov frame in a cohort of children and young people with juvenile idiopathic arthritis. Rheumatol Adv Pract, 2019, 3(2): rkz031. doi: 10.1093/rap/rkz031.
48. Greenfield S, Matta KM, McCoy TH, et al. Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies Trauma Limb Reconstr, 2019, 14(2): 65-71.
49. Arshad Z, Aslam A, Abu-Zeinah K, et al. Distraction arthroplasty in the management of osteoarthritis of the ankle: A systematic review. Foot Ankle Surg, 2022, 28(8): 1150-1162.
50. Lim JW, Eom JS, Kang SJ, et al. The effect of supramalleolar osteotomy without marrow stimulation for medial ankle osteoarthritis: second-look arthroscopic evaluation of 29 ankles. J Bone Joint Surg (Am), 2021, 103(19): 1844-1851.
51. Haraguchi N, Ota K, Tsunoda N, et al. Weight-bearing-line analysis in supramalleolar osteotomy for varus-type osteoarthritis of the ankle. J Bone Joint Surg (Am), 2015, 97(4): 333-339.
52. Yang XQ, Zhang Y, Wang Q, et al. Supramalleolar osteotomy vs arthrodesis for the treatment of Takakura 3B ankle osteoarthritis. Foot Ankle Int, 2022, 43(9): 1185-1193.
53. 杨鑫权, 张言, 王琼, 等. 踝上截骨治疗Takakura3B期踝关节炎的临床疗效分析. 足踝外科电子杂志, 2022, 9(1): 8-12.
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