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Ankle Implant
B.J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Tibial and talar implant for treatment of severe arthritis
            • 1st-generation ankle arthroplasty
              • Cemented, high rates of loosening
            • 2nd-generation ankle arthroplasty
              • Cementless, requiring less bone resection
            • Two 2nd-generation design types, though many individual systems of each
              • 2-component (fixed-bearing): Tibial and talar metal implants, with polyethylene spacer fixed to tibial component
                • Polyethylene is partially conforming articulation
                • Most frequently used type of ankle implant in USA up to now
              • 3-component (mobile-bearing): Tibial and talar metal implants, separated by polyethylene spacer
                • Polyethylene is fully conforming and mobile
                • Has been used in Europe for many years; recently approved for use by FDA, so will be seen more frequently now in USA

        IMAGING

        • Radiographic Findings

          • CT Findings

            • Imaging Recommendations

              CLINICAL ISSUES

              • Natural History & Prognosis

                Selected References

                1. Choi WJ et al: The impact of diabetes on the short- to mid-term outcome of total ankle replacement. Bone Joint J. 96-B(12):1674-80, 2014
                2. Lee AY et al: Total ankle arthroplasty: a radiographic outcome study. AJR Am J Roentgenol. 200(6):1310-6, 2013
                3. Gougoulias N et al: How successful are current ankle replacements?: A systematic review of the literature. Clin Orthop Relat Res. 468(1):199-208, 2010
                4. Besse JL et al: Clinical evaluation and radiographic assessment of bone lysis of the AES total ankle replacement. Foot Ankle Int. 2009 Oct;30(10):964-75. Erratum in: Foot Ankle Int. 30(12):vi, 2009
                5. Bestic JM et al: Postoperative evaluation of the total ankle arthroplasty. AJR Am J Roentgenol. 190(4):1112-23, 2008
                6. Bestic JM et al: Postoperative imaging of the total ankle arthroplasty. Radiol Clin North Am. 46(6):1003-15, v-vi, 2008
                7. Kopp FJ et al: Total ankle arthroplasty with the Agility prosthesis: clinical and radiographic evaluation. Foot Ankle Int. 27(2):97-103, 2006
                8. Stamatis ED et al: How to avoid specific complications of total ankle replacement. Foot Ankle Clin. 7(4):765-89, 2002
                Related Anatomy
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                References
                Tables

                Tables

                KEY FACTS

                • Terminology

                  • Imaging

                    • Clinical Issues

                      TERMINOLOGY

                      • Definitions

                        • Tibial and talar implant for treatment of severe arthritis
                          • 1st-generation ankle arthroplasty
                            • Cemented, high rates of loosening
                          • 2nd-generation ankle arthroplasty
                            • Cementless, requiring less bone resection
                          • Two 2nd-generation design types, though many individual systems of each
                            • 2-component (fixed-bearing): Tibial and talar metal implants, with polyethylene spacer fixed to tibial component
                              • Polyethylene is partially conforming articulation
                              • Most frequently used type of ankle implant in USA up to now
                            • 3-component (mobile-bearing): Tibial and talar metal implants, separated by polyethylene spacer
                              • Polyethylene is fully conforming and mobile
                              • Has been used in Europe for many years; recently approved for use by FDA, so will be seen more frequently now in USA

                      IMAGING

                      • Radiographic Findings

                        • CT Findings

                          • Imaging Recommendations

                            CLINICAL ISSUES

                            • Natural History & Prognosis

                              Selected References

                              1. Choi WJ et al: The impact of diabetes on the short- to mid-term outcome of total ankle replacement. Bone Joint J. 96-B(12):1674-80, 2014
                              2. Lee AY et al: Total ankle arthroplasty: a radiographic outcome study. AJR Am J Roentgenol. 200(6):1310-6, 2013
                              3. Gougoulias N et al: How successful are current ankle replacements?: A systematic review of the literature. Clin Orthop Relat Res. 468(1):199-208, 2010
                              4. Besse JL et al: Clinical evaluation and radiographic assessment of bone lysis of the AES total ankle replacement. Foot Ankle Int. 2009 Oct;30(10):964-75. Erratum in: Foot Ankle Int. 30(12):vi, 2009
                              5. Bestic JM et al: Postoperative evaluation of the total ankle arthroplasty. AJR Am J Roentgenol. 190(4):1112-23, 2008
                              6. Bestic JM et al: Postoperative imaging of the total ankle arthroplasty. Radiol Clin North Am. 46(6):1003-15, v-vi, 2008
                              7. Kopp FJ et al: Total ankle arthroplasty with the Agility prosthesis: clinical and radiographic evaluation. Foot Ankle Int. 27(2):97-103, 2006
                              8. Stamatis ED et al: How to avoid specific complications of total ankle replacement. Foot Ankle Clin. 7(4):765-89, 2002