title: Ankle Distraction Arthroplasty: Indications, Technique, and Outcomes.
abstract: Ankle distraction is an alternative to ankle arthrodesis or total ankle arthroplasty in younger patients with arthritis. Ankle distraction involves the use of external fixation to mechanically unload the ankle joint, which allows for stable, congruent range of motion in the setting of decreased mechanical loading, potentially promoting cartilage repair. Adjunct surgical procedures are frequently done to address lower-extremity malalignment, ankle equinus contractures, and impinging tibiotalar osteophytes. Patients can bear full weight during the treatment course. The distraction frame frequently uses a hinge, and patients are encouraged to do daily range-of-motion exercises. Although the initial goal of the procedure is to delay arthrodesis, many patients achieve lasting clinical benefits, obviating the need for total ankle arthroplasty or fusion. Complications associated with external fixation are common, and patients should be counseled that clinical improvements occur slowly and often are not achieved until at least 1 year after frame removal.
authors.affiliation: From the Department of Orthopaedic Surgery, Loyola University Chicago Stritch School of Medicine, Chicago, IL (Dr. Bernstein), the Department of Orthopaedics, Johns Hopkins University, Baltimore, MD (Dr. Reidler), and the Department of Orthopaedic Surgery, Hospital for Special Surgery, Cornell University, New York, NY (Dr. Fragomen and Dr. Rozbruch).
authors.forename: Mitchell
authors.initials: M
authors.lastname: Bernstein
authors.forename: Jay
authors.initials: J
authors.lastname: Reidler
authors.forename: Austin
authors.initials: A
authors.lastname: Fragomen
authors.forename: S Robert
authors.initials: SR
authors.lastname: Rozbruch
mesh_terms: D000843:Ankle Joint / Q000033:anatomy & histology / Q000503:physiopathology / Q000601:surgery*; D001178:Arthroplasty / Q000295:instrumentation / Q000379:methods*; D001696:Biomechanical Phenomena; D006801:Humans; D010003:Osteoarthritis / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome