N°268 - Book 1 - November 2017
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Total ankle arthroplasties: a reliable solution
By Yves Stiglitz, Fabrice Gaudot in category
Hôpital Raymond Poincaré, Garches
In addition to comfort and psychological experience, the recovery of a few degrees of dorsiflexion at the tibiotalar joint has a protective effect on neighbouring joints. This is why total ankle replacement (TAR) should be offered, even though it may act as a relay, which can be protracted in young patients, leading to ankle arthrodesis at a later stage. Third-generation TAR, developed under Prof. Thierry Judet’s leadership, is much more reliable than earlier TARs from the 1970s through the 2000s. In this article, we present the principles and technique that underpin this procedure.
Until recently, advanced cases of tibiotalar joint destruction were treated with various arthrodesis techniques. Outcomes were good according to patients, reliable according to surgeons, and had extensive scientific support. The procedure was thus validated and considered to be the gold standard in ankle surgery.
Although several long-term studies confirmed patient satisfaction despite tibiotalar mobility loss, this sacrifice caused some preoperative distress. Patients expressed a deep-rooted hope that modern medicine would bring a ‘magical’ solution, and arthrodesis was possible only when they were able to move past thoughts of a return to normality.
Long-term evolution was...
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