Ankle Replacement: How Far Have We Come?

Many diseases and chronic conditions could lead to knee or ankle replacement. Osteoarthritis is probably the major disease that leads to joint replacement. Arthritis affects the cartilage in the ankle, minimizing the range of motion.

Accident-related injuries could also lead to joint replacement. However, many do not know anybody who has undergone ankle replacement. This is because modern joint replacement surgeries are quite successful, and it is not easy to notice that a friend or family member has a replacement joint.

So, what has changed since the first ankle replacement in the 1970’s? This article will highlight milestones in the history of ankle replacement to shed more light on this innovative treatment approach.

How Joint Replacement Surgeries Started

The first joint-replacement surgery occurred in 1891, but it took many decades before ankle replacement was implemented successfully. The surgeons initially used curved ivory to replace the joint because it is accepted by the immune system.

The first metal joint was used around 1940, and the metal prosthetics became standard a decade later. Since osteoarthritis rarely affects the ankle, only a few orthopedic surgeon specialties focus on ankle replacement. Ankle problems usually develop due to abnormalities and trauma that causes fractures.

Previously, ankle arthrodesis was the standard treatment for injuries and the advanced stages of osteoarthritis, but it led to reduced motion. Therefore, there was a need for biomechanical engineers to introduce total ankle replacement, which eventually happened in the 1970s.

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First-Generation Phase

The first ball and socket replacement by Lord and Marotte was reviewed after 5.6 years, and only five out of 25 cases were satisfactory. The specialists noticed that the replacement implant was loosening or misaligned.

The failure highlighted a few issues that later led to success. The engineers realized that they needed large bone resections to ensure the bone cement fitted the implant to the talus and tibia. This leads to a high compressive load on the exposed surfaces, which leads to weakness and loosening of the early implant.

Besides, the surgeons faced other challenges because they lacked appropriate instruments. So, the first ankle-replacement surgery was frustrating, and many publications were against it.

Second-Generation Phase

This ankle replacement prosthesis had some improvements, such as the hydroxyl-apatite coat for cementless installation. There were two designs, one with two components and another with three components bearing. This ankle has one point of articulation between the tibia and talar and a polyethylene insert.

The mobile-bearing implant has a moving bearing that reduces shear forces between the talar and tibial components. Scandinavian total ankle replacement has two major components and a fixed-bearing design. It became available in the 80s and is one of the popular ankle replacement options in Europe.

Third-Generation Phase

People with osteoarthritis or ankle injuries have at least twenty ankle replacement options worldwide. The most advanced design has three components made of cobalt-chromium and a porous coating that allows cementless installation. The modern ankle prosthesis had a 90.6 percent success rate after five years since installation.

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However, some patients report postoperative complications leading to revision surgeries and secondary arthrodesis in some cases. The specialists realized that ankle arthroplasty helps manage pain in the last stage of arthritis.

As explained, the ankle replacement operations have had incredible success, with the short and midterm assessments being as high as 90 percent. Therefore, patients with arthritis or ankle injuries should go for total ankle replacement surgery. However, they should choose a reliable health facility for a quality total ankle replacement option.

5 thoughts on “Ankle Replacement: How Far Have We Come?

  1. The article was to the point and very informative by the way. The language used in this is very communicable and can be understood by me.

  2. Its an amazing and detailed article about how ankle replacements have come a long way, with recent advancements offering improved mobility and faster recovery times for patients.

  3. Needed information about this for my mother who is suffering from this problem for a long time. Thank you for this.

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