Total ankle arthroplasty: a historical perspective.
The ideal total ankle prosthesis has yet to be determined, but much has been learned from early experiences in ankle arthroplasty. Modern implants are typically more respectful of anatomic concerns, have found a happy medium of constraint, and have found novel approaches to decrease interface stress. Biologic fixation has improved on cemented results. Surgical techniques and understanding of wound healing and ligamentous deficiency have advanced. Current series still have varied results, and longer-term follow-up is needed. Despite this, some modern ankle replacements represent significant progress, with improved results and survival challenging those of arthrodesis. Further, benefits of preserved motion and avoidance of foot arthritis outstrip this traditional "gold standard." Today, tempered enthusiasm for the future of total ankle arthroplasty is again apparent. A diverse, international effort is underway to create a lasting joint implant. Building on the lessons of the past, different investigators in different countries, using markedly different prostheses, continue to work toward this goal.
Henne
Timothy D
TD
Grand Rapids Orthopaedic Surgery Residency, 200 Jefferson Street, Grand Rapids, MI 49503, USA. dwyer@umich.edu
Anderson
John G
JG
D000843:Ankle Joint / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000266:history*; D049673:History, 20th Century; D006801:Humans; D007595:Joint Prosthesis / Q000266:history*; D011474:Prosthesis Design / Q000266:history; D016879:Salvage Therapy