title: Posterior Talar Shifting in Mobile-Bearing Total Ankle Replacement.
abstract: BACKGROUND
  End-stage ankle osteoarthritis frequently involves multiplanar malalignment in both the coronal and the sagittal planes. Sagittal malalignment often includes anterior translation of the talus relative to the tibia. Restoration of the correct tibial and talar alignment is essential for the long-term survival of total ankle replacement.
  
  
  METHODS
  This study includes 66 consecutive patients who underwent total ankle arthroplasty with the Hintegra prosthesis from May 2011 to April 2014. There were 28 females (42.4%) and 38 males (57.6%) with a mean age of about 57 years (25-82 years). Patients were clinically and radiologically assessed preoperatively and at 2, 6, and 12 months postoperatively.
  
  
  RESULTS
  At 12 months postoperatively, there was a statistically significant increase in American Orthopaedic Foot & Ankle Society scores from 31.9 to 72.3. Range of motion significantly increased from 9.5 to 25.4 degrees. In addition, there was a statistically significant decrease in visual analog scale (VAS) pain score from 8.9 to 2.2. Furthermore, there was a significant increase in the Tibio-Talar ratio from 2 to 6 months postoperatively (34.6%-37.2%).
  
  
  CONCLUSIONS
  This study demonstrated significant improvements in clinical and radiologic outcomes after Hintegra total ankle arthroplasty. Significant movement of the talus occurs within the first 6 months postoperatively. This may be the result of rebalancing of muscle and ligament forces after surgery.
  
  
  METHODS
  Level IV, case series.
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Milan, Italy fusuelli@gmail.com.
authors.forename: Federico G
authors.initials: FG
authors.lastname: Usuelli
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Maccario
authors.affiliation: IRCCS Istituto Ortopedico Galeazzi, Milan, Italy Seconda Università degli Studi di Napoli, Napoli, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Manzi
authors.affiliation: University of Southern California, Los Angeles, USA.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery; D058737:Arthroplasty, Replacement, Ankle; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D016059:Range of Motion, Articular; D013628:Talus / Q000000981:diagnostic imaging*; D013977:Tibia / Q000000981:diagnostic imaging*; D064232:Visual Analog Scale
keywords: anterior translation; mobile bearing; osteoarthritis; posterior translation; talus; total ankle arthroplasty