Abstract
Total joint replacement is one of the options in surgical treatment of advanced ankle arthritis. It allows the ankle to remain mobile but, unfortunately, it does not provide the same longevity as total knee or hip replacements.
Therefore, decisions concerning the kind of treatment are very individual and depend on the clinical status and opinion of each patient. A total of 132 total ankle replacements were carried out in the period from 2004 to 2015.
The prostheses used included the Ankle Evolutive System (AES) in 52 patients, Mobility Total Ankle System (DePuy) in 24 patients and, recently, Rebalance Total Ankle Replacement implant in 53 patients. Three patients allergic to metal received the Taric prosthesis.
Revision arthroplasty using the Hintegra prosthesis was carried out in four patients. The average follow-up was 6.1 years (1-11 years).
The average AOFAS score of the whole group increased from 33.2 before surgery to 82.5 after it. The primary indication had an important role.
Arthroplasty outcomes were poorer in patients with post-traumatic arthritis than in those with rheumatoid arthritis or primary arthritis. In patients with post-traumatic arthritis, the average AOFAS score rose to 78.6 due to restricted motion of the ankle, and some patients continued to have pain when walking.
The average AOFAS score in a total of 49 patients who had rheumatoid arthritis or primary arthritis reached a value of 86.4. Total ankle arthroplasty is a complicated surgical procedure potentially associated with various technical problems.
The occurrence of complications is indirectly related to the experience of the orthopaedist performing surgery; literature data show that the number of complication decreases with an increased frequency of ankle replacements done.