Total ankle arthroplasty is the newest successful treatment for ankle arthritis. The historical standard ankle fusion has significant complications and long-term negative effects. Intermediate term results of second generation ankle replacement designs are excellent. KSF Orthopaedic Center, PA is proud to have one of the few surgeons in Houston with both the training and the experience in implantation of the Agility Total Ankle Replacement. Patients with ankle arthritis have gained a significant treatment option.
The rate of a successful first time ankle fusion is 85%. In other words, 15% of patients will fail primary fusions and require a revision procedure. When a successful fusion is obtained, pain is eliminated from the ankle joint and patients are routinely satisfied with the early results of the procedure. However, lack of ankle joint motion wreaks havoc on the joints of the hindfoot and midfoot. Most patients with ankle arthritis are young and surrounding joint degeneration following fusion is universal. Degenerative changes in these joints are routinely noted on X-ray examination and symptoms begin several years following fusion. No replacement options exist for these foot joints. Routinely, a fusion of the hindfoot follows years after a successful ankle fusion, giving the patient a ‘staged’ pantalar fusion. This procedure eliminates all motion in and around the ankle leading to a short stiff-legged gait. Patients with below knee amputations function far better.
The Agility Total Ankle Replacement (Depuy, Warsaw, IN) is the only device approved by the FDA for routine use. This implant replaces all articular surfaces and can be used in both primary and revision cases. Furthermore, the Agility is the only implant that has been used to revise failures of other experimental ankle replacements. It has six different component sizes to match the variety of patient characteristics. Only Orthopaedic surgeons who have undergone a rigorous training course and are certified by Depuy are permitted to use the implant.
In the hip and knee most arthritis develops from primary degenerative changes. The ankle is surprisingly resistant to idiopathic degeneration and most ankle arthritis follows traumatic injury. Ankle sprains with subsequent chronic instability and ankle fractures represent two commonly cited causes of ankle arthritis
Total ankle arthroplasty eliminates pain, preserves ankle motion and permits a more normal gait. Unlike a fusion, it decreases the stress transmitted to the rest of the foot. Recently, multiple authors have shown high degrees of satisfaction and low rates of revision or fusion. It is a viable choice for patients who have ankle arthritis. |
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