An Alumina Ceramic Total Talar Prosthesis for Osteonecrosis of the Talus.
BACKGROUND
Treatment of osteonecrosis of the talus is challenging. Total talar replacement has the potential to restore the function of the ankle joint without an associated leg-length discrepancy. The purpose of the present study was to investigate postoperative function and pain after total talar replacement in patients with osteonecrosis of the talus.


METHODS
Fifty-five ankles in fifty-one consecutive patients with osteonecrosis of the talus who were treated with a total talar replacement from 2005 to 2012 were included in the investigation. Scores according to the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale and the Ankle Osteoarthritis Scale (AOS) were assessed before surgery and at the final follow-up evaluation.


RESULTS
According to the JSSF ankle-hindfoot scale, the score for pain improved from a mean (and standard deviation) of 15 ± 9.4 points (range, 0 to 20 points) to 34 ± 5.6 points (range, 20 to 40 points); the score for function, from 21.2 ± 9.7 points (range, 4 to 38 points) to 45.1 ± 4.0 points (range, 37 to 50 points); the score for alignment, from 6.0 ± 2.8 points (range, 5 to 10 points) to 9.8 ± 0.9 points (range, 5 to 10 points); and the total score, from 43.1 ± 17.0 points (range, 11 to 68 points) to 89.4 ± 8.4 points (range, 76 to 100 points). According to the AOS scale, the score for "pain at its worst" improved from a mean of 6.1 ± 3.3 points (range, 0 to 9.9 points) to 2.0 ± 1.7 points (range, 0 to 6.3 points).


CONCLUSIONS
Prosthetic talar replacement is a useful procedure for patients with osteonecrosis of the talus as it maintains ankle function.
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi: a-tani@naramed-u.ac.jp.
Akira
A
Taniguchi
Department of Orthopaedic Surgery, Nishi Nara Central Hospital, 1-15 Tsurumai Nishi-cho, Nara-shi, Nara 631-0022, Japan.
Yoshinori
Y
Takakura
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi: a-tani@naramed-u.ac.jp.
Yasuhito
Y
Tanaka
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi: a-tani@naramed-u.ac.jp.
Hiroaki
H
Kurokawa
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi: a-tani@naramed-u.ac.jp.
Kiyonori
K
Tomiwa
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi: a-tani@naramed-u.ac.jp.
Takenori
T
Matsuda
Department of Orthopaedic Surgery, Nara Medical University, 840 Shijyo-cho, Kashihara, Nara 634-8522, Japan. E-mail address for A. Taniguchi: a-tani@naramed-u.ac.jp.
Tsukasa
T
Kumai
Department of Orthopaedic Surgery, Nara Prefecture General Medical Center, 1-30-1 Hiramatsu, Nara-shi, Nara 631-0846, Nara, Japan.
Kazuya
K
Sugimoto
D000328:Adult; D000368:Aged; D000537:Aluminum Oxide; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D058737:Arthroplasty, Replacement, Ankle / Q000379:methods*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D013628:Talus / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
D000537:Aluminum Oxide