Surgeon Training and Complications in Total Ankle Arthroplasty

Abstract

No identified training method had a statistically demonstrable positive impact on preparing surgeons for performing total ankle replacement. Some of these findings are likely generic for total ankle replacements and not restricted to any class or design of implant. Surgeon initial use of total ankle replacement needs to be done with caution and serious consideration.

Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

“…In young patients, debridement, resurfacing, and realignment have limited indications [2][3][4][5] . Ankle arthrodesis and ankle replacement, currently the most commonly performed procedures, have recognized potential complications and long-term problems [6][7][8][9][10][11][12] . Joint distraction is a promising treatment approach for ankle osteoarthritis; however, its efficacy and role are not well defined.…”

Total Ankle Arthroplasty in Patients with Hereditary Hemochromatosis

“…The use of TAA as an alternative to ankle fusion is continuously expanding, but reported results have been limited to small patient numbers and shortterm followups. An important concern regarding TAA is the high rate of intraoperative complications [20,27,31,35] and high rate of reoperations after this procedure [36]. We therefore determined (1) the intraoperative and postoperative complications, including surgical revision for any reason; (2) the prosthesis component stability; (3) whether TAA provides pain relief in the midterm; and (4) the midterm functional outcome, including ROM and quality of life.…”

“…Although TAA is becoming more commonly used, the relative benefits of TAA continue to be one of the most debated topics in foot and ankle surgery [11]. First, there is a steep learning curve associated with performing TAA [20,27,31,35]. Intraoperative complications are common and include medial or lateral malleolar fractures and lacerations to the tendons (posterior tibial tendon, flexor digitorum/hallucis longus), and nerves (deep peroneal nerve, superficial peroneal nerve) [20,27,31,35].…”

“…First, there is a steep learning curve associated with performing TAA [20,27,31,35]. Intraoperative complications are common and include medial or lateral malleolar fractures and lacerations to the tendons (posterior tibial tendon, flexor digitorum/hallucis longus), and nerves (deep peroneal nerve, superficial peroneal nerve) [20,27,31,35]. Furthermore, TAA is associated with a higher rate of major revision surgery than ankle fusion, ranging from 9% to 23% at 1 to 5 years for TAA and 5% to 11% for ankle fusion at 1 to 5 years [36].…”

The bright future for total ankle replacements

“…Success after TAA, however, depends heavily on surgeon experience [3][4][5][6][7] and it is difficult to gain expertise in each of the growing number of prostheses. Many of the best outcomes are reported by surgeons involved at least in the initial design of the implants under study.…”