Surgical treatment of deforming osteoarthritis of the ankle: a systematic review of the literature

Background: Osteoarthritis of the ankle is a very common disabling disease, occurring in people of working age. In the early stages, conservative therapy can be effective, but if ankle arthritis progresses to the terminal stages, the question arises of choosing the right method of surgical treatment. Surgical treatment of late stages of ankle osteoarthritis mainly involves a choice between total ankle replacement and ankle arthrodesis.

The purpose of this article: To determine the best treatment for end-stage deforming osteoarthritis of the ankle based on available research data.

Materials and methods: A review of the literature over the past 10 years was carried out in such databases as PubMed, Scopus, Google Scholar, eLibrary. Articles, original studies, case reports, and previous systematic reviews of the literature were found.

Results: 338 studies were found reflecting the results of the discussed surgical treatment options. Aſter reviewing abstracts of articles, applying inclusion criteria and exclusion criteria, 25 articles were selected for a detailed review. Of these, 12 reflected the results of total arthroplasty, 8 – arthrodesis, and 5 studies directly comparing the two methods. The results of the comparison of studies are presented in the form of tables. Both methods of treating the terminal stages of deforming osteoarthritis of the ankle joint show good medium-term and long-term results. Aſter total arthroplasty, a higher overall rate of complications was noted, and aſter arthrodesis, a higher rate of revision surgeries was observed. Total ankle arthroplasty shows better functional result.

Discussion: Both methods of treatement of the terminal stages of deforming osteoarthritis of the ankle show good medium-term and long-term results. However, due to the high overall complication rate aſter total ankle replacement, it is not possible to clearly identify a preferable technique. Further studies of the long-term results of endoprosthesis replacement and arthrodesis of the ankle joint are necessary.

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