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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 4, 481-486.
doi: 10.1302/0301-620X.91B4.20855  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Total ankle replacement in patients with significant pre-operative deformity of the hindfoot

S. A. Hobson, BMedSci, BM, BS, MRCS1; A. Karantana, MBBS, MRCS1; and S. Dhar, MBBS, MS, MCh(Orth), FRCSEd(Orth)1

1 Department of Trauma and Orthopaedics Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK.

Correspondence should be sent to Miss S. A. Hobson; e-mail: hobson_sally{at}hotmail.com

We carried out 123 consecutive total ankle replacements in 111 patients with a mean follow-up of four years (2 to 8). Patients with a hindfoot deformity of up to 10° (group A, 91 ankles) were compared with those with a deformity of 11° to 30° (group B, 32 ankles). There were 18 failures (14.6%), with no significant difference in survival between groups A and B. The clinical outcome as measured by the post-operative American Orthopaedic Foot and Ankle Surgeons score was significantly better in group B (p = 0.036). There was no difference between the groups regarding the post-operative range of movement and complications. Correction of the hindfoot deformity was achieved to within 5° of neutral in 27 ankles (84%) of group B patients. However, gross instability was the most common mode of failure in group B. This was not adequately corrected by reconstruction of the lateral ligament.

Total ankle replacement can safely be performed in patients with a hindfoot deformity of up to 30°. The importance of adequate correction of alignment and instability is highlighted.




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B. S. Kim, W. J. Choi, Y. S. Kim, and J. W. Lee
Total ankle replacement in moderate to severe varus deformity of the ankle
J Bone Joint Surg Br, September 1, 2009; 91-B(9): 1183 - 1190.
[Abstract] [Full Text] [PDF]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General