Post-traumatic arthritis is among the most often recorded kind of ankle arthritis. Inflammation, soreness, and a loss of movement and flexibility are all symptoms of the incapacitating illness known as ankle arthritis (Clough et al. 1353). An efficient option to reduce the discomfort of ankle arthrodesis and to obtain proper treatment is to undergo Total Ankle Replacement (TAR), also known as Total Ankle Arthroplasty (TAA). The reason behind choosing the given type of ankle arthroplasty is that, while ankle arthritis occurs less frequently than hip or knee arthritis, the degree of physical and psychological impairment it causes is comparable to severe musculoskeletal conditions (Clough et al. 1353). At the same time, research on the effects of total ankle replacement implant devices is proliferating, indicating the success and efficiency of the surgery.
There are several steps in the surgery, and it begins with implementing general anesthesia on a patient, ensuring that they experience as little pain as possible. Then, the surgeon will perform an incision in the muscle of the ankle region and possibly a second incision on the foot after cleansing the afflicted location. The tibia and talus will have the affected parts removed by the specialist (Clough et al. 1354). The doctor will then connect the prosthetic joint parts from mental to the fragments of the residual bones. Additionally, the surgeon may likely place a plastic component between the newly placed metal joint gaps to allow easy sliding motion. Other essential modifications could be made later by the healthcare professional. The surgeon will carefully seal the tissue and muscle surrounding the ankle and feet.
As for the complications of the TAA, the first one involves broken bone during surgery. From 3.1% to 9% of intraoperative medial malleolar fractures have been recorded (Wang and Brown 342). The usage of cutting medical equipment and the implant design might influence the frequency of injuries (Wang and Brown 342). With the mobility system, injuries have been recorded more commonly than with previous systems. With total ankle replacement, there is a significant learning slope, and problems have been seen more frequently with previous surgeries performed by the practitioner.
Another complication and risk of the surgery is a technical or positioning mistake. The kind of prosthesis utilized, the jigs employed, or medical incompetence might all blame any technical fault that transpires (Wang and Brown 343). The estimated rate fluctuates between 5.2% and 6% (Wang and Brown 343). According to research, it is the second most frequent issue (Wang and Brown 343). Intraoperative fluoroscopy could lower this incidence by enabling precise cutting block positioning, although some of this incidence will still be attributable to inexperienced surgeons (Wang and Brown 343). The achievement of a well-fixed, coordinated, and secure prosthesis has a significant role in the lifetime and functionality of TAA. In addition to prosthesis and tool selection, accomplishing this relies on the surgeon’s proficiency in addressing preoperative deformation and establishing tissue balance.
Lastly, when it comes to prognosis for patients, total ankle replacement, with its improved results, has emerged in recent years as the cornerstone of care for the final stage of ankle osteoarthritis. At 5 years, 8 years, and 15 years, the overall survival rate was 93%, 86%, and 82%, respectively (Kvarda et al. 883). The most frequent cause of modification was aseptic loosening (Kvarda et al. 883). The implant will last 10 years in 90% of instances (Kvarda et al. 883).
Most of the time, they may function much longer, although occasionally, the implant can stop working in less than 10 years. Moreover, it should be mentioned that ankle replacements may become loose over time. Pain and edema may develop if the metal component is moved within the bone (Kvarda et al. 883). However, no research directly compares one whole ankle replacement model to another. In this sense, there is a controversy that there might be a joint infection in total ankle replacement in a post-operative setting (Kvarda et al. 883). Still, not much research with a bigger and diversified sample has been done to corroborate this statement.
Works Cited
Clough, T. M., F. Alvi, and H. Majeed. “Total Ankle Arthroplasty: What Are the Risks? A Guide to Surgical Consent and a Review of the Literature.” Bone Joint Journal, vol.100, no. 10, 2018, pp.1352-1358. Web.
Kvarda, Peter, et al. “Long-Term Survival of HINTEGRA Total Ankle Replacement in 683 Patients: A Concise 20-Year Follow-up of a Previous Report.” The Journal of Bone and Joint Surgery, vol. 104, no. 10, 2022, pp.881-888. Web.
Wang, Henry, and Scott R. Brown. “The Effects of Total Ankle Replacement on Ankle Joint Mechanics During Walking.” Journal of Sport and Health Science, vol. 6, no. 3, 2017, pp.340-345. Web.