Mobile-bearing total ankle arthroplasty: A fundamental assessment of the clinical, radiographic and functional outcomes

Abstract

Ankle arthritis often leads to significant impairments for the patient. As total ankle arthroplasty (TAA) with use of fixed-bearing (2-component) total ankle prostheses has a high rate of early failures, fusion of the ankle joint is, until today, considered to be the standard surgical treatment for end-stage ankle arthritis. TAA with use of a mobile-bearing design became available in 1981 with the development of the New Jersey Low Contact Stress (LCS®, DePuy, Warsaw, Indiana) ankle prosthesis in the USA and in 1986 with the development of the Scandinavian Total Ankle Replacement (STAR, Waldemar Link, Hamburg, Germany) prosthesis in Denmark. The LCS ankle prosthesis was introduced in 1988 at the Slotervaartziekenhuis, Amsterdam, this hospital thus becoming the first non-designer hospital in Europe to use a mobile-bearing ankle prosthesis. With growing experience, this method became our preferred surgical treatment for the arthritic ankle with end-stage disease, at first in patients with inflammatory arthritis, later also in patients with osteoarthritis (mostly of posttraumatic origin). Since TAA as a reliable treatment option is, until today, still subject of debate, an in-depth evaluation of its clinical, radiographic and functional outcomes was performed in order to properly assess its current position in the armamentarium of the modern foot and ankle surgeon