title: Alternatives to ankle implant arthroplasty for posttraumatic ankle arthrosis.
abstract: Various surgical options beyond implant arthroplasty are available to treat posttraumatic ankle arthrosis. Conservative options are usually employed in combination and include the use of nonsteroidal anti-inflammatories, bracing, and orthoses, as well as injections of intra-articular corticosteroid and hyaluronic acid. If these conservative treatments fail, surgical intervention can be entertained. Alternatives to total ankle implant arthroplasty include (1) arthroscopic debridement, (2) arthrodiastasis, (3) peri-articular resurfacing using allograft or cartilage transplantation, and (4) peri-articular osteotomies to correct angular, rotational, or translational malalignment. However, ankle arthrodesis is the standard technique for end-stage ankle arthrosis. This article reviews the literature and presents an in-depth surgical technique for each procedure. The article also describes how to prevent and address the most common complications.
authors.affiliation: Department of Orthopaedics/Podiatry Division, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7776, San Antonio, TX 78229, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zgonis
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Roukis
authors.forename: Vasilios
authors.initials: V
authors.lastname: Polyzois
mesh_terms: D016512:Ankle Injuries / Q000150:complications; D000843:Ankle Joint / Q000601:surgery*; D019643:Arthroplasty, Replacement; D001182:Arthroscopy; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D019736:Prostheses and Implants