Indications Primary osteoarthritis (e.g., degenerative disease) Systemic arthritis (e.g., rheumatoid arthritis) Posttraumatic osteoarthritis (if instability and malalignment are manageable) Secondary osteoarthritis (e.g., infection, avascular necrosis; if at least two thirds of the talar surface is preserved) Salvage for failed total…
Indications Posttraumatic/degenerative/primary/secondary arthritis of tibiotalar and subtalar joints Rheumatoid arthritis of tibiotalar and subtalar joints Significant osteonecrosis of the talus Diabetic patients with unstable Charcot neuroarthropathy or peripheral neuropathy Failed ankle arthrodesis Failed total ankle replacement Skeletal defects after tumor…
Indications Ankle arthrodesis Symptomatic end-stage ankle arthritis (posttraumatic, inflammatory, primary) Failed nonoperative management External fixation History of sepsis/osteomyelitis at the arthrodesis site ( Fig. 55.1A–B ) Compromised soft tissue envelope Inadequate bone stock to support internal fixation at the arthrodesis…
Indications Posttraumatic or idiopathic ankle osteoarthritis with severe bony deformity Inflammatory ankle arthropathy (i.e., rheumatoid arthritis) Unmanageable ankle joint instability or neurologic disorders Distinct osseous defects (i.e., posttraumatic, postinfectious, after failed total ankle replacement) Indications Pitfalls Acute or chronic osteomyelitis…
Indications End-stage ankle arthritis Caused by Hemophilia Hemochromatosis Trauma Osteochondral defects Gout Rheumatoid arthritis Sepsis Osteoarthritis Ankle instability Indications Pitfalls Major bone loss may require a segmental allograft. Infection may require a more extensive débridement than an arthroscopic fusion may…
Indications Malaligned ankles with medial osteoarthritis Malunions after distal tibial fractures or malleolar fractures Realignment prior to total ankle replacement (TAR) or ankle fusion Corrections after malpositioned TAR or ankle fusion Medial osteochondritis dissecans of the talus Indications Pitfalls Loss…
Indications Physically active patients with lateral ankle joint degeneration associated with valgus malalignment (e.g., posttraumatic malalignment, ankle joint instability) Lateral osteochondritis dissecans of the talus associated with valgus malalignment Realignment prior to total ankle replacement (TAR) or ankle fusion Indications…
Indications Painful ankle dorsiflexion due to impingement of bone and/or soft tissue in the anterior ankle joint Loss of ankle dorsiflexion due to anterior tibiotalar spurs Indications Pitfalls Severe anterior ankle arthritis with loss of anterior joint space, or anterior…
Indications Large osteochondral lesions (OCLs) that are bigger than one third of the articular surface in at least one plane (sagittal and/or coronal) A history of persistent pain for >1 year after conservative treatment or previous surgical treatment Indications Pitfalls…
Osteochondral autograft transfer system (OATS) procedure consists of transplanting one or various osteochondral cylinders from a donor site to a osteochondral defect to supply the smoothness and support of the articular surface that has been lost. Indications Stage III–IV osteochondral…