Total ankle replacement - 14 year experience with the cementless ESKA ankle prothesis

摘要

The introduction of the cementless total ankle replacement to treat severe osteoarthritis since the early 1990s showing excellent results has reduced the indication of arthrodesis. In our hospital the fusion of the talocrural joint is now only performed in a few cases with exeptional conditions. Our experience and results with our cementless ankle prosthesis (2 components) developed in cooperation with the ESKA company and implanted since 1990 in 117 patients (63% post-traumatic) are reported: 75% of patients were able to walk normally without pain, the other 25% reported a remarkable improvement. The preoperative persisting pain has completly disappeared in all patients, only 25 patients complained of an intermit-tend pain under fairly severe loading. The overall range of motion by 20% of patients reached 40-60°, 72% presented a range of 20-40° and only 7.5% of patients showed a range of less than 20°. The Kofoed ankle score used for comparision with other studies showed an improvement from 37.61 points preoperative to 90.4 points postoperative. According to our good results and the results of other studies, we believe that a cementless ankle prosthesis can reach a survival time of 20 or more years. We see also some advantages for our two component prosthesis vs the three component prostheses in some difficult cases of arthrosis, especially for defects of the maleoleoli.