Posttraumatic Ankle Arthritis: An Update on Conservative and Surgical Management

Abstract

T he purpose of this manuscript is to provide current information regarding the examination, conservative treatment, and surgical treatment for individuals with posttraumatic arthritis. The 3 major categories of arthritis are inflammatory, osteoarthritis, and posttraumatic arthritis. Rheumatoid arthritis is the most common form of inflammatory arthritis; however, it does not always affect the ankle.35 It has been reported that 10% to 50% of individuals with rheumatoid arthritis have ankle involvement. 8,16,48,60,83 The mechanical properties of the tibiotalar articular cartilage make it durable and efficient at equalizing stress. These properties may reduce the risk of osteoarthritis at the ankle. 7,37,75,77,80,86 Posttraumatic arthritis is more common than osteoarthritis at the ankle. Saltzman et al 71 reported that osteoarthritis and posttraumatic arthritis accounted for 12% and 70% of ankle arthritis cases, respectively.

Treatment of Isolated Ankle Osteoarthritis with Arthrodesis or the Total Ankle Replacement: A Comparison of Early Outcomes

“…Mild to moderate ankle arthritis can often be managed with an ankle foot orthoses and a rocker-bottom shoe, provided that no significant varus/valgus deformity is present 2,4). Ankle arthrodesis and replacement are two common surgical treatment options for end-stage ankle osteoarthritis.…”

Evaluation of Clinical Effect of Ankle Arthrodesis and Total Ankle Arthroplasty for End-stage Ankle Arthritis

“…Uncorrectable deformities preclude this from happening and should not be considered for ankle replacement. Similarly, patients with active lifestyle interests that involve rapid acceleration and deceleration forces on the articulating surfaces will likely prematurely wear their ankle replacement [17,18,25]. In our study, six patients in B group and three patients in A group showed radiological evidence of degeneration of the talonavicular joint and the subtalar joint.…”

“…In our study, for older and less demanding end-stage ankle arthritis patients, a. total ankle arthroplasty is recommended. Whereas younger with a high activity level, no adjacent joint arthritis, and posttraumatic end-stage ankle arthritis, an arthrodesis is recommended [17,18].…”

Nonmedicinal therapy in the management of ankle arthritis

“…This may be attempted through the use of offloading strategies such as assistive devices [26]. A single point cane can decrease vertical loading by 11-25% [27,28].…”