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The e-mémoires of the Académie Nationale de Chirurgie

Ankle osteoarthritis – arthrodesis or prosthesis ?

JARDE O | VERNOIS J | MASSY S | ALOVOR G | BELLOT F

Seance of wednesday 28 april 2004 (pas de sujet Principal)

Abstract

The ankle joint is complex and subjected to three-dimensionalstress. Ankle osteoarthritis can be treated by arthrodesis with goodresults and good reliability or by prosthesis with a good range ofmotion but a short follow up. Authors have studied several prostheses.Sixty three ankle prostheses were implanted between 1990 and2002. We studied clinical and radiological results, using dynamicX-ray in plantar and dorsal flexion. With a one year follow up, 62%of the results are excellent or good. Ten secondary arthrodeses wereneeded.Thirty three primary arthrodeses were reviewed during the sameperiod. Long term results showed 69% of excellent or good results.Spheric prostheses must be given up. Instability, unalignment, osteonecrosisof the talus and severe osteoarthritis (talo-tibial andsubtalar OA) require a primary arthrodesis. Furthermore, simpleosteoarthritis can be treated with ankle prosthesis, whatever the ageof the patient.