Ankle OA & Athrodesis/Replacement

Question 1

who is prone to ankle OA

Answer 1

footballers

Question 2

what movement can result in anterior damage and osteophyte formation

Answer 2

repeated dorsiflexion

Question 3

what can anterior osteophytes cause

Answer 3

pain during dorsiflexion resulting in impingement

Question 4

what can improve pain on dorsiflexion

Answer 4

removing anterior osteophytes (cheilectomy)

Question 5

what are the two surgical options for advanced OA of the ankle causing significant pain

Answer 5

arthrodesis or ankle replacement

Question 6

which of the two surgical measures can afford better outcomes due to some preservation of movements

Answer 6

ankle replacement

Question 7

what is the trouble with ankle replacements

Answer 7

• substantial compressive and shearing force is placed across relatively small bones
• fixation of implants to distal tibia and talus can be a problem with high rates of early loosening, component sinkage and failure

Question 8

why should ankle replacements be limited to the elderly

Answer 8

once failures occurs patients usually need fusion which shortens the limb

Question 9

what is a contra-indication to ankle replacement

Answer 9

major malalignment

Question 10

why might ankle arthrodesis be a more reliable option than ankle replacement

Answer 10

re-operation rates are lower