Total ankle arthroplasty is an evolving area of modern orthopaedics that is gaining renewed interest after early failures. Implant design has improved with a greater understanding of the complex biomechanics of the ankle joint. Modern ankle prostheses consist of three components, including either a fixed or mobile polyethylene-bearing. Only a handful of implants are FDA-cleared for use in the United States, and the experience with some of these implants is limited. Although it is difficult to draw a consensus from the limited studies available, the trend has been towards lower complications and failures than with early implants. Also, multiple recent studies purport better gait and function with total ankle arthroplasty. Equivalence with ankle arthrodesis has been suggested but has yet to be conclusively proven. Despite this renewed enthusiasm, surgeons should be aware that complications still exist and can be devastating even in experienced hands. Currently, ankle arthroplasty appears to be a viable alternative to ankle arthrodesis in selected patients.
aOrthopaedic Resident, Dept of Orthopaedics, UMDNJ-New Jersey Medical School, Newark, NJ, USA
bAttending Surgeon, Orthopaedic Foot & Ankle Center, Arlington, VA, USA
cAssociate Professor and Chief, Foot and Ankle Division, Dept of Orthopaedics, UMDNJ-New Jersey Medical School, USA
Correspondence to Sheldon Lin, MD, 90 Bergen St DOC 7300, Newark, NJ 07901, USA Tel: +1 (973) 972 2184; fax: +1 (973) 972 1080; e-mail: firstname.lastname@example.org
The corresponding author has received clinical and basic research support from BMTI and DePuy and is a consultant for Tornier.