Efficacy Analysis Of Total Ankle Arthroplasty To Treat The Ankle Joint Osteoarthritis

Objective：Observe the efficacy analysis of total ankle arthroplasty to treat the ankle jointosteoarthritisMethods:A retrospective analysis of the China-Japan Union Hospital of Jilin UniversityOrthopaedics from October2009to October2013because of ankleosteoarthritis patients hospitalized for total ankle arthroplasty in22cases,including14males and8females, the youngest32years old, maximum78years, mean age55years. Duration of6years to27years diseased parts: leftankle joint in9cases,13cases of right ankle joint. Symptoms of ankle pain,swelling varying degrees, joint mobility, difficulty walking, etc., to alleviate thepain at rest, activity. According Kofoed [1] rating criteria, pain (50points),function (30points), walking aids and joint activity (20points), total score of100points, due to the importance of the former two and meter divisionmultiple.Results:Patients were followed up for5months to4years, an average of2.3years.2days after operation take ankle radiographs, after1month,2months,3months,6months,1year, once a year later, the radiographs and clinical follow-up. As of October2013, two cases were lost, the other three cases failed because of theremoteness referral to the hospital, complete follow-up in17patients, fivecases of necrosis appeared incision, the incision healed after carefully dressing,anterior tibial tendon exposed two cases, a routine debridement and suturehealing, another example of skin defects due to defects accusing him of twosuction VSD underwent12days after the transfer of flap surgery healing.Intraoperative fracture of the medial malleolus two cases, one case of lateralmalleolus fractures, fractures no significant shift, line cannulated screws,postoperative cast immobilization for12weeks. Imaging no prosthesisdisplacement, loosening and sinking, without radiographic failure cases. Theaverage hospital stay was21days. According Kofoed [1] score, patients in pain,function and activity areas are much better than before surgery (P <0.05), thereare significant differences.Conclusions:1. Ankle fusion is the preferred treatment of ankle osteoarthritis, but withimproving and ankle joint replacement surgery experience is gained ankleprosthesis, ankle fusion "preferred" status has been challenged. TAA surgerycan not only relieve pain, but also retains the ankle joint activities to improvelimping gait, ankle joint function and reduce the incidence of osteoarthritisapproaching improve the quality of life of patients. These are clinicaladvantages of ankle replacement. So, TAA should be the preferred treatment ofankle osteoarthritis. Perfected prosthesis, a large accumulation of surgical experience, so artificial ankle arthroplasty with hip and knee replacement asbroad prospects.2. TAA has its own complications: incision superficial skin necrosis, anteriortibial tendon exposure, intraoperative lateral malleolus fractures, only to avoidthe occurrence of complications, in order to ensure the success of the artificialankle replacement, in order to play clinical advantages out of it3. And THA and TKA compared to ankle replacement although there is along history, but the development is relatively slow, and the incidence of ankleosteoarthritis far below the hip, knee osteoarthritis incidence, and the limitednumber of ankle replacement surgery while complex, long operation time,higher requirements for surgical techniques, combined with our lack of surgicalexperience in this field, resulting in a technical mistake (caused by surgerymedial malleolus, lateral malleolus fractures, etc.), which have some impact onour retrospective study.4. Although artificial total ankle replacement can be a good activity andimprove ankle function, but it is with the artificial hip and knee replacement, aswill inevitably have to face the life of the prosthesis and other issues, so wepreoperative patients rigorous assessment of the patient to choose their owntreatment programs.5. The small number of cases were retrospectively analyzed, the resultsobtained on the accuracy and comprehensiveness has some limitations, furtheranalysis is still needed a larger sample. At the same time the relatively short follow-up to its long-term efficacy need time to verify.