Abstract
Purpose of the study: THe peritalar joints are centered around the talus. They are stabilized by powerful ligaments and oriented along precise alignments. Osteoarthritis of the ankle joint can result from architectural anomalies of the peritalar joints which can be corrected with appropriate surgery. Errors in assessing these disorders is often the cause of failure and consequently the poor reputation of ankle prostheses. This emphasizes the importance of the clinical and radiological preparation. The Méary view with comparative films if possible, enables accurate analysis of the alignments and bone relations as well as the different anomalies of the peritalar joints.
Material and methods: Our experience with more than 500 ankle prostheses implanted since 1989 has led to sometimes proposing complementary corrective procedures before the arthroplasty. Here we present 62 cases of AES total ankle arthroplasty (37 men and 25 women, mean age 55 years) with seven years follow-up. Several types of osteotomies were used: fibular, tibial, malleolar, calcaneal. These osteotomies were sometimes associated or combined with other procedures for ligament plasty fo example.
Results: The overall score was based on the AFCP 100 point functional scale. The score improved from 31.2 on average preoperatively to 78.8 postoperatively. Complications were: involuntary intraoperative fracture, wound healing disorder, reflex dystrophy, nonunion, prosthetic loosening.
Conclusion: Quality Méary views enable an adapted study of the peritalar disorders and the causes of the tibiotarsal osteoarthritic degradation in order to establish a well-adapted surgical plan with the goal of re-establishing normal anatomy. Favorable outcome and thus be expected for ankle prostheses. The indication for arthroplasty can thus be discussed for difficult cases to date treated by arthrodesis.
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