History
Since the early 1970s, the disadvantages of ankle arthrodesis and the excellent results attained by arthroplasty at other human joints have encouraged numerous prosthesis designs also for the ankle. In the following decade, the disappointing results of long-term follow-up clinical studies of the pioneering designs has left ankle arthrodesis as the surgical treatment of choice for these patients. More modern designs have produced better results, contributing to a renewed interest in total ankle arthroplasty over the past decade.
Nearly all designs from pioneers featured two-components; these designs have been categorized as incongruent and congruent, according to the shape of the two articular surfaces. After the early unsatisfactory results of the two-component designs, most of the more recent designs feature three-components, with a polyethylene meniscal bearing interposed between the two metal bone-anchored components. This meniscal bearing should allow full congruence at the articular surfaces in all joint positions in order to minimize wear and deformation of the components. Poor understanding of the functions of the structures guiding ankle motion in the natural joint (ligaments and articular surfaces), and poor restoration of these functions in the replaced joint may be responsible for the complications and revisions.
Read more about this topic: Ankle Replacement
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