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Artroplastia total do tornozelo

Updated Sep 2026
Illustration: ankle

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

Por que esta cirurgia foi recomendada

A artrite do tornozelo significa que a superfície lisa no interior da articulação se desgastou, fazendo com que os ossos friccionem entre si. Geralmente, ela surge após uma fratura ou entorse grave do tornozelo. Pode ser tão incapacitante quanto a artrite do quadril. Para a maioria das pessoas com esse problema de longa data, iniciamos o tratamento não cirúrgico, como modificação das atividades físicas, fisioterapia e uso de talas; a cirurgia é considerada apenas quando essas medidas não trazem melhoria suficiente.

A artroplastia total do tornozelo substitui as superfícies desgastadas da articulação por um implante artificial. É uma das duas opções cirúrgicas para casos avançados de artrite do tornozelo; a outra é a artrodese do tornozelo, na qual os ossos são unidos para crescerem juntos. Discutiremos ambas as opções com você. A satisfação dos pacientes com a artroplastia do tornozelo costuma ultrapassar 90%; a cirurgia tem como objetivo aliviar a dor e restaurar a mobilidade, permitindo que você caminhe e mantenha uma vida ativa com mais conforto.

Antes da operação

Após a programação da cirurgia, providenciamos os exames de imagem necessários: radiografias do tornozelo em carga e, às vezes, ressonância magnética ou ultrassonografia para avaliar detalhadamente a articulação, a cartilagem e os tecidos moles ao redor. No dia da operação, você deverá parar de comer e beber sete horas antes. Pedimos esse período de sete horas, em vez de um tempo menor, para que possamos antecipar a cirurgia caso a agenda cirúrgica permita. Alguns medicamentos precisam ser suspensos antes da operação; seu cirurgião informará quais são e quando devem ser interrompidos. Leve uma lista por escrito de todos os medicamentos que toma, use roupas largas e confortáveis, e providencie alguém para levá-lo para casa após a cirurgia. Caso tenha outras condições médicas, poderá ser necessário realizar exames de sangue ou uma avaliação com o anestesista.

No dia da cirurgia

Você virá à unidade de admissão cirúrgica do hospital, onde será registrado e preparado para a sala de operações. Conhecerá o anestesista, responsável pela aplicação da anestesia. Esta cirurgia é realizada sob anestesia geral. Às vezes, é adicionado um bloqueio nervoso regional para alívio da dor pós-operatória; o anestesista conversará sobre isso com você no próprio dia. Em seguida, você será levado à sala de operações, onde a cirurgia será realizada.

Você acordará na área de recuperação, onde enfermeiros cuidarão de você enquanto a anestesia vai passando. Assim que estiver estável, será encaminhado para o quarto ou poderá ir para casa, dependendo do tipo de procedimento e da evolução da sua recuperação.

Como é realizada a operação

A artroplastia total do tornozelo substitui as superfícies desgastadas da articulação por componentes artificiais, geralmente feitos de metal e plástico. O cirurgião remove o osso e a cartilagem danificados das extremidades dos ossos que formam o tornozelo, depois os modela para que se ajustem às novas superfícies articulares. Os novos componentes são fixados no lugar para que se movimentem suavemente um contra o outro, da mesma forma que um tornozelo saudável.

A operação é realizada através de uma incisão na parte frontal do tornozelo. Alguns modelos de prótese também utilizam uma pequena haste inserida no osso principal da perna, a fim de manter o implante estável. Durante o mesmo procedimento, o cirurgião pode alongar um tendão tenso na parte posterior do tornozelo, se isso ajudar na flexão posterior do tornozelo posteriormente.

Após a colocação e verificação do implante, a incisão é fechada com pontos e coberta por um curativo. Esse curativo deve ser mantido por cerca de 10 dias, conforme descrito na seção de recuperação.

O tipo exato de implante utilizado varia, e os modelos continuam a ser aprimorados à medida que os cirurgiões descobrem quais formas e materiais funcionam melhor. O seu cirurgião explicará o plano cirúrgico para o seu tornozelo antes da operação, inclusive se serão necessários passos adicionais com base nos resultados dos exames de imagem.

Após a operação

Você acordará na sala de recuperação, sob a vigilância das enfermeiras, enquanto o efeito da anestesia passa. Assim que estiver estável, será transferido para o quarto ou poderá ir para casa. Sua equipe informará se você poderá ir para casa no mesmo dia ou se precisará ficar uma noite no hospital. O controle da dor será planejado para antes que a anestesia perca o efeito; avise a enfermeira caso a dor não diminua. O seu tornozelo será envolto em curativos, que permanecerão por cerca de 10 dias; por favor, não os retire antes disso, a menos que receba instruções em contrário. Trocaremos ou removeremos os curativos quando o examinarmos. Logo após a operação, você receberá ajuda para ficar de pé e dar alguns passos, utilizando muletas ou um andador para apoio. Alguém deve permanecer com você nas primeiras 24 horas após chegar em casa.

Recuperação

Nos primeiros dias, o foco é o repouso e a redução do inchaço. O seu tornozelo ficará dolorido e inchado, e a pele pode apresentar hematomas. Manter o pé elevado acima do nível do coração, aplicar compressas de gelo envoltas em uma toalha e tomar os analgésicos conforme prescrito ajudam a aliviar esses sintomas. O inchaço geralmente atinge o pico nos primeiros dias e depois diminui gradualmente; porém, pode aparecer e desaparecer por algum tempo, especialmente após ficar em pé por períodos prolongados.

Logo após a cirurgia, você receberá ajuda para se levantar e dar alguns passos, utilizando muletas ou uma andador. O fisioterapeuta orientará exercícios para manter o restante da perna em movimento e, quando o cirurgião considerar que a cicatrização está adequada, para recuperar a mobilidade e a força do tornozelo. Você usará uma bota ortopédica ou outro tipo de suporte até que o tornozelo se estabilize; também receberá instruções sobre como colocar peso no pé conforme ele for ficando pronto para isso. Em casa, mantenha o pé elevado ao sentar, caminhe distâncias curtas conforme orientado e evite ficar em pé por muito tempo. Dormir de costas com o pé elevado costuma ser a posição mais confortável.

A recuperação varia de pessoa para pessoa. Alguns conseguem ficar estáveis em pé mais cedo que outros; o inchaço também pode persistir por mais tempo do que o esperado, sem que isso indique algum problema. O seu cronograma pode ser diferente do de outras pessoas, e o cirurgião e o fisioterapeuta o guiarão em cada etapa. Assim que o inchaço diminuir e o tornozelo ganhar mais mobilidade, caminhar e realizar atividades cotidianas se tornarão progressivamente mais fáceis.

O que pode dar errado

A maioria dos pacientes se recupera bem, mas, ocasionalmente, podem surgir problemas. O seu cirurgião e a equipe o monitoram de perto para detectar qualquer problema precocemente.

Às vezes, o osso ao redor da nova articulação se desgasta lentamente. Você pode notar uma dor surda perto do implante ou sentir que o tornozelo está menos estável do que antes. Isso é identificado nas radiografias realizadas durante os acompanhamentos; portanto, mantenha os compromissos de retorno mesmo que o tornozelo pareça estar bem. Se o desgaste for detectado cedo, geralmente é possível tratá-lo sem a necessidade de refazer toda a artroplastia.

Infecções ao redor da nova articulação são raras, mas graves. Fique atento a uma dor profunda e latejante que não melhora com analgésicos comuns, vermelhidão que se espalha a partir da incisão ou vazamento de líquido da ferida. Você também pode sentir febre e calafrios. Informe-nos imediatamente caso perceba algum desses sinais, ou vá ao pronto-socorro se não se sentir bem.

Um coágulo sanguíneo pode causar inchaço e sensibilidade súbitos na panturrilha, às vezes acompanhados de calor ou sensação de peso na perna. Se o coágulo atingir os pulmões, pode provocar falta de ar ou dor no peito. Esses sinais exigem atenção imediata; portanto, vá ao pronto-socorro ou peça ajuda, em vez de esperar.

O osso na borda do tornozelo pode rachar durante a colocação das novas peças. Geralmente isso é detectado durante a cirurgia e tratado na hora, mas pode exigir um período mais longo usando bota ou gesso depois. Se sentir uma dor aguda e nova nos saliências ósseas dos lados do tornozelo logo após a cirurgia, avise-nos.

A cicatriz na frente do tornozelo pode demorar a cicatrizar. Fique atento a bordas da ferida se abrindo, aumento da vermelhidão ou secreção. Mencione isso na consulta de acompanhamento ou ligue para a clínica, pois algumas feridas precisam de cuidados adicionais da nossa equipe.

Às vezes, forma-se osso extra próximo à nova articulação, provocando uma sensação de compressão na frente do tornozelo, especialmente ao levantar o pé. Se essa sensação persistir e for dolorosa, uma pequena cirurgia minimamente invasiva pode resolver o problema.

Caso a prótese se desgaste ou falhe anos depois, ainda existem opções de tratamento, como outra artroplastia ou transformar o tornozelo em uma artrodese, na qual os ossos são mantidos unidos para crescerem juntos.

A tabela de complicações nesta página lista as taxas típicas, caso você queira conhecer os detalhes.

Quando nos contactar

A maioria dos problemas manifesta-se logo no início, e uma intervenção rápida facilita o seu tratamento. Contacte-nos se tiver febre, vermelhidão crescente ou secreção na ferida, ou dor que continua a piorar em vez de melhorar. Dirija-se às urgências se sentir inchaço ou sensibilidade súbitos na panturrilha, dificuldade em respirar ou dor no peito, pois estes podem ser sinais de um coágulo sanguíneo. Dirija-se às urgências também se perder a sensibilidade no pé ou não conseguir movê-lo. Se não tiver a certeza se algo é normal, ligue para a clínica e ajudaremos a decidir.


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Anatomy & Pathophysiology

Bony Anatomy

  • The ankle mortise is formed by the tibial plafond, medial malleolus, and lateral malleolus [5].
  • The ankle mortise articulates with the dome of the talar body [5].
  • The talar dome is wider anteriorly and narrower posteriorly [5].
  • The ankle mortise widens 1 to 1.5 mm during motion from plantar flexion to dorsiflexion [5].
  • Medial and superior clear spaces appear wider with the foot in plantar flexion [5].
  • A simplified model of the ankle joint has a horizontal axis from anteromedial to posterolateral [5].
  • A simplified model of the ankle joint has a coronal axis from superomedial directed distally and laterally to the tip of the fibula [5].
  • The distal fibula has a convex medial surface [5].
  • The incisura fibularis is the concave surface of the distal lateral tibia [5].
  • The fibula rotates approximately 2 degrees within the incisura during ankle motion and ambulation [5].
  • Ankle dorsiflexion results in external rotation and proximal translation of the fibula [5].

Ligamentous Anatomy

  • Lateral ankle ligaments function as restraints to varus and inversion forces at the ankle [5].
  • The anterior talofibular ligament (ATFL) originates from the anteroinferior aspect of the lateral malleolus, 1 cm proximal to its tip [5].
  • The anterior talofibular ligament extends to the lateral aspect of the talar neck [5].
  • The calcaneofibular ligament (CFL) extends from the tip of the lateral malleolus to the lateral aspect of the calcaneus [5].
  • The posterior talofibular ligament (PTFL) extends from the posterior lateral malleolus to the posterolateral talus [5].
  • The ATFL is the weakest ankle ligament [5].
  • The PTFL is the strongest ankle ligament [5].
  • The distal tibiofibular joint and fibula provide stability against lateral talar translation [5].
  • The deltoid ligament complex is the primary ankle stabilizer during stance [5].
  • The deep deltoid ligament extends from the apex of the medial malleolus to the medial talar body [5].
  • The deep deltoid ligament functions primarily to resist lateral talar translation and external rotation [5].
  • The posterior deep deltoid is the most important component of the deep deltoid ligament [5].
  • The superficial deltoid ligament extends from the distal medial malleolus to the navicular bone, sustentaculum tali of calcaneus, medial talus, and spring ligament [5].
  • The superficial deltoid ligament functions primarily to resist valgus and eversion ankle forces [5].
  • The deltoid ligament consists of superficial and deep layers, with at most six bands [11].
  • Only three bands of the deltoid ligament are constant: the tibionavicular ligament, tibiospring ligament, and deep posterior tibiotalar ligament [11].
  • The superficial layer of the deltoid ligament originates from the anterior malleolus and inserts into the navicular, neck of the talus, sustentaculum tali, and posteromedial talar tubercle [11].
  • The tibiocalcaneal portion of the superficial deltoid ligament is the strongest component and resists eversion of the calcaneus [11].
  • The deep portion of the deltoid ligament is the primary medial stabilizer of the ankle joint [11].
  • The deep deltoid ligament is organized into two short, thick, discrete bands: the anterior and posterior deep tibiotalar ligaments [11].
  • The anterior and posterior deep tibiotalar ligaments are intra-articular but extrasynovial [11].
  • The deep posterior band comprises the largest band of the deltoid complex [11].
  • The anterior deep tibiotalar ligament arises from the anterior malleolus and attaches to the medial aspect of the talus [11].
  • The posterior deep tibiotalar ligament originates from the posterior malleolus and inserts on the medial body of the talus [11].
  • The deltoid ligament has a rich vascular supply from three extraosseous sources: the medial tarsal artery, posterior tibial artery, and tibialis anterior artery [11].
  • The deltoid ligament also has intraosseous vascular supply from either the talus or the medial malleolus [11].
  • The deep deltoid ligament has the highest load to failure at 713.8 N ± 69.3 compared with the lateral collateral ligaments [11].
  • The dominant mode of failure for the deep deltoid ligament is an intrasubstance rupture near its talar insertion [11].
  • The failure of the superficial deltoid ligament is most commonly at its insertion on the anterior malleolus [11].

Biomechanics & Motion

  • The primary functions of the foot and ankle are to provide weight-bearing support and forward ambulation [5].
  • The ankle is responsible for most sagittal plane motion of the foot and ankle [5].
  • Ankle plantar flexion ranges from 23 to 48 degrees [5].
  • Ankle dorsiflexion ranges from 10 to 23 degrees [5].
  • The ankle contributes to inversion, eversion, and rotation [5].

Neurovascular Anatomy

  • The superficial peroneal nerve penetrates the deep fascia and lies subcutaneously 8 to 10 cm proximal to the tip of the lateral malleolus [9].
  • The anterior tibial artery can be palpated beneath the superior extensor retinaculum 4 to 5 cm proximal to the distal articular surface of the tibia [9].
  • The deep peroneal nerve accompanies the anterior tibial artery and lies between the tendons of the anterior tibial and extensor digitorum longus [9].
  • The deep peroneal nerve lies just lateral to the anterior tibial artery [9].
  • The saphenous nerve is located just medial or posterior to the saphenous vein in a slightly deeper plane 3 to 5 cm proximal to the tip of the medial malleolus [9].

Pathophysiology of Injury

  • More than 75% of ankle ligament injuries involve the lateral ligament complex, particularly the ATFL and CFL [12].
  • Medial ligament injuries are usually seen in association with a fracture or joint injury [12].
  • In an ATFL sprain, tenderness is maximal just distal and slightly anterior to the lateral malleolus [12].
  • The deltoid ligament primarily prohibits eversion and abduction [11].
  • The deep deltoid ligament resists external rotation when the foot is dorsiflexed [11].
  • The deep deltoid ligament is responsible for the greatest restraint against lateral translation [11].
  • Valgus tilting of the talus within the mortise requires complete rupture of both the superficial and deep deltoid ligaments [11].
  • Isolated rupture of the deltoid ligament without lateral ligamentous or fibular injury is rare [11].
  • Syndesmotic injury, lateral ligamentous injury, and fibular fractures are common associations with deltoid injury [11].
  • The criteria for diagnosis of medial instability include a feeling of giving way, medial ankle joint pain, and a correctable valgus or pronation deformity [11].
  • Medial instability is reinforced by excess motion in external rotation, eversion, valgus, and/or posterior translation [11].
  • With complete deltoid injury, a valgus AP stress radiograph shows talar tilt and/or lateral translation of the talus [11].
  • Most incomplete deltoid injuries are normal on standard radiographic imaging [11].
  • MRI is the imaging modality of choice for defining injury to the deltoid ligaments and associated structures [11].
  • Ankle arthroscopy allows direct assessment of the deltoid ligament with lateral stress applied to the talus [11].

Investigations

Osteochondral Lesions

  • Osteochondral lesions of the ankle are seen in up to 70% of ankle sprains and 75% of ankle fractures [15, 16].
  • The most common location for osteochondral lesions is the medial talar dome [15, 16].
  • Modern data indicate that the most common location for medial talar dome lesions is central, contradicting historical beliefs that the posterior location was more common [15, 16].
  • Medial talar dome lesions are larger and deeper than lateral lesions [15, 16].
  • Lateral talar dome lesions are less common than medial lesions [15, 16].
  • Lateral talar dome lesions are more often unstable, displaced, or symptomatic than medial lesions [15, 16].
  • Lateral talar dome lesions are often refractory to conservative measures [15, 16].
  • Physical examination for osteochondral lesions demonstrates deep pain over the ankle joint line [15, 16].
  • Palpation often does not reproduce the symptoms described by patients with osteochondral lesions [15, 16].
  • Ankle effusion is common in patients with osteochondral lesions [15, 16].
  • AP, mortise, and lateral weight-bearing ankle x-rays may not demonstrate subtle osteochondral lesions [15, 16].
  • CT scan is helpful for determining the integrity of subchondral bone and identifying cysts in osteochondral lesions [15, 16].
  • MRI is sensitive for all osteochondral lesions [15, 16].
  • The edema pattern on MRI frequently overestimates the severity of osteochondral injury [15, 16].
  • Linear fluid signal deep to subchondral bone on MRI indicates an unstable osteochondral injury [15, 16].
  • MRI has a sensitivity of 92% for predicting stable versus unstable osteochondral lesions [15, 16].

General Imaging and Diagnosis

  • Advanced imaging is often helpful in the diagnosis of foot and ankle injuries when combined with a thorough clinical examination [18].
  • MRI is used for the evaluation of tibiofibular syndesmotic ligaments [3].
  • MRI is used for the evaluation of posterior tibial tendon dysfunction [3].
  • MRI is used for the evaluation of anterolateral soft tissue impingement of the ankle [3, 20].
  • MRI is used for the evaluation of osteochondral lesions of the talus [3].
  • MRI is used for the diagnosis of ligamentous and chondral pathology in the ankle [3].
  • MRI and stress radiography are used in the evaluation of chronic lateral ankle instability [3].
  • MRI is used in the pre-operative evaluation of the anterior talofibular ligament in chronic ankle instability [3].
  • MRI is used for the diagnosis of ruptures of the tibialis posterior tendon [3].
  • MRI is used for the imaging evaluation of traumatic ligamentous injuries of the ankle and foot [3].
  • MRI is used for the diagnosis of plantar plate injury [3].
  • MRI findings are associated with symptoms in patients with chronic ankle sprain [3].
  • MRI is used for the evaluation of chronic Achilles tendon ruptures [3].
  • MRI is used for the evaluation of peroneal tendon abnormalities [17].
  • MR imaging is used for the evaluation of entrapment neuropathies of the lower extremity, including the ankle and foot [21].
  • Ultrasonography is used for the examination of the deltoid ligament in bimalleolar equivalent fractures [19].
  • Point-of-care ultrasonography is used in the diagnosis and management of superficial peroneal nerve entrapment [21].
  • MRI lacks additional diagnostic value for stability assessment of the ankle mortise in supination-external rotation-type ankle fractures [19].
  • Preoperative computed tomography scans are used in operative planning for malleolar ankle fractures [19].
  • Axial CT imaging is used to evaluate normal tibiofibular relationships at the syndesmosis [19].
  • Radiographic evaluation of the normal distal tibiofibular syndesmosis is a standard diagnostic consideration [19].
  • Fluoroscopy is used to assess if the syndesmosis is reduced [19].
  • The ankle fracture spur sign is pathognomonic for a variant ankle fracture [19].
  • Evaluation of posterior malleolar fractures and the posterior pilon variant is performed in operatively treated ankle fractures [19].
  • Stability criteria for nonoperative ankle fracture management are established via radiographic assessment [19].
  • Gravity stress radiographs are used to assess deltoid ligament integrity and medial clear space measurements [4].
  • Radiographic identification of primary lateral ankle structures is possible [4].
  • Comparison of magnetic resonance imaging to physical examination is performed for syndesmotic injury after lateral ankle sprain [4].

Treatment

Complications and Revision

  • Revision of failed total ankle arthroplasty can be performed as a hindfoot fusion [1].
  • Infection in total ankle arthroplasty requires specific diagnostic and treatment protocols [1].
  • Patient-related risk factors for periprosthetic joint infection have been analyzed in a cohort of 6977 total ankle arthroplasties [1].
  • Risk factors for symptomatic deep-vein thrombosis exist in patients after total ankle replacement who received routine chemical thromboprophylaxis [1].
  • Perioperative outcomes of total ankle arthroplasty differ when performed at an orthopaedic specialty hospital versus an academic teaching hospital [1].
  • Salvage of failed total ankle arthroplasty can be achieved with fusion using structural allograft and internal fixation [1].
  • Bone lysis of the AES total ankle replacement is subject to clinical evaluation and radiographic assessment [1].
  • Heterotopic ossification can occur after total ankle arthroplasty [1].
  • Risks associated with total ankle arthroplasty have been evaluated in the literature [1].
  • Short-term complications are associated with procedures performed through separate incisions during total ankle replacement [1].
  • The ankle arthritis score is associated with the need for revision surgery [1].
  • Patient risk factors do not impact 90-day readmission and emergency department visitation after total ankle arthroplasty [1].
  • Supramalleolar osteotomy is a treatment for tibial component malposition in total ankle replacement [1].
  • Hindfoot arthritis progression and arthrodesis risk occur after total ankle replacement [1].
  • Arthroscopic debridement is a management option after total ankle arthroplasty [1].
  • Failures of total ankle replacement can be managed with the Agility total ankle arthroplasty [1].
  • Blood transfusion during total ankle arthroplasty is associated with increased in-hospital complications and cost [1].
  • A three-grade classification of complications has been assessed for total ankle replacement [1].
  • Soft tissue reconstruction is performed after total ankle arthroplasty [1].
  • Operative wound complications occur following total ankle arthroplasty [1].
  • Bone grafting of bone cysts is an outcome management strategy after total ankle arthroplasty [1].
  • Secondary arthrodesis is performed after total ankle arthroplasty [1].
  • Short-term perioperative complications and mortality occur after total ankle arthroplasty in the United States [1].
  • The incidence of symptomatic thromboembolic events is low after total ankle arthroplasty without routine use of chemoprophylaxis [1].
  • Evaluation and management strategies exist for the painful total ankle arthroplasty [1].
  • Anterior heterotopic ossification at the talar neck can occur after total ankle arthroplasty [1].
  • Salvage arthrodesis is performed for failed total ankle replacement [1].
  • Platelet-rich plasma has been evaluated for its efficacy in incision healing after total ankle replacement using the Agility system [1].
  • Computed tomography has been evaluated for its added information on radiographic analysis in detecting periprosthetic osteolysis after total ankle arthroplasty [1].
  • The impact of complications in total ankle replacement and ankle arthrodesis has been analyzed with a validated outcome measurement [1].
  • Revision rates after total ankle arthroplasty have been reported in sample-based clinical studies and national registries [1].
  • Acute hematogenous periprosthetic joint infection in total ankle arthroplasty can be treated with irrigation, debridement, and polyethylene exchange [1].
  • Cigarette use is associated with complication rates and outcomes following total ankle arthroplasty [1].
  • Heterotopic ossification occurs after primary total ankle arthroplasty [1].
  • Delayed onset medial malleolar pain following total ankle arthroplasty has a defined etiology and treatment [1].
  • Periprosthetic fractures occur in total ankle replacement [1].
  • Postoperative range of motion trends have been documented following total ankle arthroplasty [2].
  • Total ankle arthroplasty outcomes have been compared for post-traumatic and primary osteoarthritis [2].
  • Total ankle arthroplasty has been reported in France [2].
  • Results of total ankle arthroplasty have been published [2].
  • The success of current ankle replacements has been evaluated in a systematic review of the literature [2].
  • The 10-year survival of total ankle arthroplasties was reported on 780 cases from the Swedish ankle register [2].
  • Outcomes after total ankle arthroplasty have been reported from worldwide arthroplasty registers [2].
  • Trends in total ankle arthroplasty and revisions have been analyzed in the Medicare database [2].
  • Inconsistency in the reporting of adverse events in total ankle arthroplasty has been identified in a systematic review [2].
  • Trends in the use of total ankle replacement and ankle arthrodesis have been analyzed in the United States Medicare population [2].
  • Changes in pain, function, and gait mechanics two years following total ankle arthroplasty performed with two modern fixed-bearing prostheses have been documented [2].
  • Trends in treatment of advanced ankle arthropathy by total ankle replacement or ankle fusion have been analyzed [2].
  • The utilization of total ankle replacement in the United States has been assessed [2].
  • Total ankle replacement was studied in a population-based study of 515 cases from the Finnish arthroplasty registry [2].
  • Practice patterns in total ankle replacement and ankle fusion in the United States have been compared [2].
  • Patient and practice trends in total ankle replacement and ankle arthrodesis in the United States from 2007 to 2013 have been analyzed [2].
  • The evolution of the technology and future applications of total ankle replacement have been discussed [2].

Complications

  • Revision of failed total ankle arthroplasty to a hindfoot fusion is a documented salvage procedure [1].
  • Perioperative outcomes for total ankle arthroplasty differ when performed at an orthopaedic specialty hospital versus an academic teaching hospital [1].
  • Salvage of failed total ankle arthroplasty can be performed with fusion using structural allograft and internal fixation [1].
  • Heterotopic ossification is a recognized complication after total ankle arthroplasty [1].
  • The risks associated with total ankle arthroplasty have been specifically evaluated [1].
  • Supramalleolar osteotomy is used to treat tibial component malposition in total ankle replacement [1].
  • A three-grade classification of complications in total ankle replacement has been assessed [1].
  • Anterior heterotopic ossification at the talar neck occurs after total ankle arthroplasty [1].
  • Computed tomography has been evaluated for its ability to add information on radiographic analysis in detecting periprosthetic osteolysis after total ankle arthroplasty [1].
  • The impact of complications in total ankle replacement and ankle arthrodesis has been analyzed using a validated outcome measurement [1].
  • Inconsistency exists in the reporting of adverse events in total ankle arthroplasty [2].

References

[1] Campbell S Operative Orthopaedics 4 Volume Set. Reported Outcomes of Ankle Arthroplasty Compared With Ankle Arthrodesis > COMPLICATIONS AND REVISION.

[2] Campbell S Operative Orthopaedics 4 Volume Set. Reported Outcomes of Ankle Arthroplasty Compared With Ankle Arthrodesis > REFERENCES.

[3] Campbell S Operative Orthopaedics 4 Volume Set. REFERENCES > FOOT AND ANKLE.

[4] Campbell S Operative Orthopaedics 4 Volume Set. REPAIR OF ACUTE RUPTURE OF LATERAL LIGAMENTS > ACUTE ANKLE LIGAMENT INJURIES, CHRONIC ANKLE INSTABILITY.

[5] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > BIOMECHANICS OF THE FOOT AND ANKLE.

[9] Campbell S Operative Orthopaedics 4 Volume Set. MULTIPLE Z-PLASTY RELEASE OF A CONGENITAL RING > ANKLE BLOCK.

[11] Orthopaedic Knowledge Update Sports Medicine 6. Ankle and Foot Injuries and Other Disorders > Ankle Sprains > Medial Ankle Injury.

[12] Apley And Solomon S Concise System Of Orthopaedics And Trauma. INJURIES OF THE ANKLE.

[15] Miller S Review Of Orthopaedics. SECTION 16 PATELLAR TRACKING IN TOTAL KNEE ARTHROPLASTY > OSTEOCHONDRAL LESIONS.

[16] Miller S Review Of Orthopaedics. OSTEOCHONDRAL LESIONS.

[17] Campbell S Operative Orthopaedics 4 Volume Set. MULTIPLE Z-PLASTY RELEASE OF A CONGENITAL RING > PERONEAL TENDONS.

[18] Orthopaedic Knowledge Update Sports Medicine 6. Ankle and Foot Injuries and Other Disorders > Summary.

[19] Orthopaedic Knowledge Update Trauma. Ankle Fractures > Annotated References.

[20] Campbell S Operative Orthopaedics 4 Volume Set. ARTHROSCOPIC EXAMINATION AND DEBRIDEMENT OF THE ANKLE JOINT > IMPINGEMENT.

[21] Campbell S Operative Orthopaedics 4 Volume Set. COMBINED HAMMER TOE AND MALLET TOE DEFORMITY WITH ASSOCIATED DOUBLE CORNS > REFERENCES > TARSAL TUNNEL SYNDROME.

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