Total ankle replacement. Review and critical analysis of the current status

Biomechanics of the ankle joint and clinical outcomes of total ankle replacement

“…In cadaveric and gait studies, the rotation has been shown to range between 10 • to 12 • (Stauffer, 1979). It is the varying centre of rotation that allows the talus to glide and slide within the ankle mortise during PF and DF (Lundberg et al, 1989;Bauer et al, 1996). Also, the curvature of the talus and the distal tibia show varying radii (Waugh et al, 1976;Bauer et al, 1996) that allow horizontal rotations to occur in the foot or leg with movements of the ankle.…”

Total Ankle Replacement Compatible with Ligament Function Produces Mobility, Good Clinical Scores, and Low Complication Rates: An Early Clinical Assessment

“…Previous designs of TAA focused exclusively on the geometry of the prosthetic components in relation to the morphologic features of the intact articular surface of the talus [5,8,17,28]. A mathematical analysis (Fig.…”

Finite element analysis of a total ankle replacement during the stance phase of gait

“…When conservative treatments fail, the affected joints can be surgically treated by arthrodesis or by total ankle replacement (TAR). Since the early 1970's, several studies have highlighted the poor performance of TAR, as demonstrated by outcomes of several midand long-term follow-up clinical studies (Bauer et al, 1996;Giannini et al, 2000). TAR is considered the least successful implant of the lower limb and arthrodesis is still considered the treatment of choice for severe ankle arthritis (Crenshaw, 1992).…”

“…However, beyond the ability to support high functional loads and the remarkable duration, arthrodesis results in high incidence of nonunion, secondary degenerative changes at neighbouring joints, high incidence of post-operative infection and, mainly, total loss of motion at the tibiotalar level (Demetriades et al, 1998). These limitations of arthrodesis, coupled with more encouraging results of current TAR designs, have contributed to a renewed interest in ankle arthroplasty over the past decade (Bauer et al, 1996;Gould et al, 2000a, b;Neufeld and Lee, 2000;Saltzman et al, 2000). In part, the early failure of TAR was due to the lack of suitable pre-clinical tests to adequately assess the likely performance.…”