11:29 AM

Ankle replacement: A new gold standard for arthritis

Orthopedics Today discusses the increased use of total ankle replacement (TAR) to treat ankle arthritis in the past decade among experts including HSS foot and ankle surgeon Scott J. Ellis, MD.

Dr. Ellis said, “Total ankle replacement is definitely growing, and it has particularly grown over the last 15 years as we have had new and better implants.”

Both ankle fusions and ankle replacements come with the risk of needing additional surgery. Dr. Ellis explained a second procedure may also be needed among patients with a TAR if they develop cysts in the bone or experience loosening or an infection.

He said, “If the implant becomes loose or it becomes infected, then you have to take it out and revise it and we know that the results of revision are never as good as the primary total ankle.”

He continued, “You could also convert the total ankle replacement to a fusion, but the problem is then you take out the implant and there is a hole there, essentially, because of the bone that you have taken out plus the implant, and so it is not easy to get an ankle to fuse at that point.”

One important item to research is whether there is an ideal position of the TAR implant that makes it function better, Dr. Ellis noted.

“There are so many degrees in components to how you put them in, meaning if it is in varus or valgus, how it is turned, how it is rotated, how high or low you put the implant. I just think there are so many variables of how we put the replacement in that we need to understand how those influence outcomes,” he underscored.

Read the full article at Healio.com/orthopedics.