Skip to main content
SpringerLink
Log in

Diffuse Ankle Osteoarthritis

  • Chapter
  • First Online:
Foot and Ankle Disorders

  • 1822 Accesses

Abstract

Ankle arthritis is a debilitating condition that affects lives of patients to the same magnitude physically as end-stage kidney disease, congestive heart failure and end-stage hip arthritis. The ankle carries the highest load of all joints in the body and therefore is at risk of degenerative wear. The most common cause of ankle arthritis is trauma; therefore these patients are often 10–15 years younger than patients with end-stage arthritis of the hip and the knee.

Conservative treatment consists of joint injections, physical therapy and orthosis/shoe modifications. Surgical treatment is divided into procedures that preserve the joint and those that do not. The first group aims to reduce the symptoms and slow the degenerative wear. Joint preserving options include osteotomies, tendon transfers, ligament reconstruction, distraction arthroplasty and open or arthroscopic debridement. Non-preserving options include ankle fusion and ankle arthroplasty. Both are indicated in end-stage arthritis; however, controversy exists on when to choose one over the other. Reoperation rates, infections and major complications occur more often in ankle arthroplasty. Adjacent joint arthritis is a concern in ankle fusion and treatment of this condition is very challenging.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sammarco J. Biomechanics of the ankle: surface velocity and instant centre of rotation in the sagittal plane. Am J Sports Med. 1977;5:231–4.

    Article  CAS  Google Scholar 

  2. Huch K, Kuettner KE, Dieppe P. Osteoarthritis in ankle and knee joints. Semin Arthritis Rheum. 1997;26(4):667–74.

    Article  CAS  Google Scholar 

  3. Saltzman CL, Salamon ML, Blanchard GM, et al. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J. 2005;25:44–6.

    PubMed  PubMed Central  Google Scholar 

  4. Knupp M, Ledermann HP, Magerkurth O, Hintermann B. The surgical tibiotalar angle: a radiological study. Foot Ankle Int. 2005;26:713–5.

    Article  Google Scholar 

  5. Hvid I, Rasmussen O, Jensen NC, Nielsen S. Trabecular bone strength profiles at the ankle joint. Clin Orthop Relat Res. 1985;199:306–12.

    Article  Google Scholar 

  6. Kapandji IA. Das obere Sprunggelenk. In: Kapandji IA, editor. Funktionelle Anatomie der Gelenke, Band 47. Enke Verlag; 1987. pp. 150–63.

    Google Scholar 

  7. Michelson JD, Schmidt GR, Mizel MS. Kinematics of a total arthroplasty of the ankle: comparison to normal ankle motion. Foot Ankle Int. 2000;21:278–84.

    Article  CAS  Google Scholar 

  8. Rasmussen O, Tovberg-Jensen I. Mobility of the ankle joint: recording of rotatory movements in the talocrural joint in vitro with and without the lateral collateral ligaments of the ankle. Acta Orthop Scand. 1982;53:155–60.

    Article  CAS  Google Scholar 

  9. Lundberg A, Goldie I, Kalin B, Selvik G. Kinematics of the ankle / foot complex, part 1: plantar flexion and dorsiflexion. Foot Ankle. 1989;9:194–200.

    Article  CAS  Google Scholar 

  10. Lundberg A, Svennson OK, Nemeth G, Selvik G. The axis of rotation of the ankle joint. J Bone Joint Surg Br. 1989;71:94–9.

    Article  CAS  Google Scholar 

  11. Saltzman CL, el-Khoury GY. The hindfoot alignment view. Foot Ankle Int. 1995;16(9):572–6.

    Article  CAS  Google Scholar 

  12. Schmid T, Krause FG. Conservative treatment of asymmetric ankle osteoarthritis. Foot Ankle Clin. 2013;18(3):437–48.

    Article  Google Scholar 

  13. Karatosun V, Unver B, Ozden A, Ozay Z, Gunal I. Intra-articular hyaluronic acid compared to exercise therapy in osteoarthritis of the ankle. A prospective randomized trial with long-term follow-up. Clin Exp Rheumatol. 2008;26(2):288–94.

    CAS  PubMed  Google Scholar 

  14. Saltzman CL, Hillis SL, Stolley MP, Anderson DD, Amendola A. Motion versus fixed distraction of the joint in the treatment of ankle osteoarthritis: a prospective randomized controlled trial. J Bone Joint Surg. 2012;94(11):961–70.

    Article  Google Scholar 

  15. van Valburg AA, van Roermund PM, Marijnissen AC, et al. Joint distraction in treatment of osteoarthritis (II): effects on cartilage in a canine model. Osteoarthr Cartil. 2000;8(1):1–8.

    Article  Google Scholar 

  16. Nguyen MP, Pedersen DR, Gao Y, Saltzman CL, Amendola A. Intermediate term follow-up after ankle distraction for treatment of end-stage osteoarthritis. J Bone Joint Surg. 2015;97(7):590–6.

    Article  Google Scholar 

  17. Marijnissen AC, Van Roermund PM, Van Melkebeek J, et al. Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: proof of concept in an open prospective study and in a randomized controlled study. Arthritis Rheum. 2002;46(11):2893–902.

    Article  Google Scholar 

  18. Ploegmakers JJ, van Roermund PM, van Melkebeek J, et al. Prolonged clinical benefit from joint distraction in the treatment of ankle osteoarthritis. Osteoarthr Cartil. 2005;13(7):582–8.

    Article  CAS  Google Scholar 

  19. Marijnissen AC, Hoekstra MC, Pré BC, et al. Patient characteristics as predictors of clinical outcome of distraction in treatment of severe ankle osteoarthritis. J Orthop Res. 2014;32(1):96–101.

    Article  CAS  Google Scholar 

  20. Chalayon O, Wang B, Blankenhorn B, et al. Factors affecting the outcomes of uncomplicated primary open ankle arthrodesis. Foot Ankle Int. 2015;36(10):1170–9.

    Article  Google Scholar 

  21. Coester LM, Saltzman CL, Leupold J, et al. Long-term results following ankle arthrodesis for post-traumatic arthritis. J Bone Joint Surg. 2001;83A(2):219–28.

    Article  Google Scholar 

  22. Zaidi R, Cro S, Gurusamy K, et al. The outcome of total ankle replacement: a systematic review and meta-analysis. Bone Joint J. 2013;95B(11):1500–7.

    Article  Google Scholar 

  23. Mann JA, Mann RA, Horton E. STARankle: long-term results. Foot Ankle Int. 2011;32(05):473–84.

    Article  Google Scholar 

  24. Basques BA, Bitterman A, Campbell KJ, Haughom BD, Lin J, Lee S. Influence of surgeon volume on inpatient complications, cost, and length of stay following total ankle arthroplasty. Foot Ankle Int. 1987;37(10):1046–51. https://doi.org/10.1177/1071100716664871.

    Article  Google Scholar 

  25. Lampley A, Gross CE, Green CL, et al. Association of cigarette use and complication rates and outcomes following total ankle arthroplasty. Foot Ankle Int. 2016. https://doi.org/10.1177/1071100716655435.

  26. Kessler B, Knupp M, Graber P, Zwicky L, Hintermann B, Zimmerli W, Sendi P. The treatment and outcome of peri-prosthetic infection of the ankle: a single cohort-centre experience of 34 cases. Bone Joint J. 2014;96-B(6):772–7. https://doi.org/10.1302/0301-620X.96B6.33298.

    Article  CAS  PubMed  Google Scholar 

  27. Easley ME, Vertullo CJ, Urban WC, Nunley JA. Review total ankle arthroplasty. J Am Acad Orthop Surg. 2002;10(3):157–67.

    Article  Google Scholar 

  28. Zanolli D, Nunley J, Easley M. Subtalar fusion rate in patients with previous ipsilateral ankle arthrodesis. Foot Ankle Int. 2015;36(9):1025–8. https://doi.org/10.1177/1071100715584014.

    Article  PubMed  Google Scholar 

  29. Hintermann B, Barg A, Knupp M, Valderrabano V. Conversion of painful ankle arthrodesis to total ankle arthroplasty. J Bone Joint Surg. 2009;91(4):850–8. https://doi.org/10.2106/JBJS.H.00229.

    Article  PubMed  Google Scholar 

  30. Cracchiolo A III, Cimino WR, Lian G. Arthrodesis of the ankle in patients who have rheumatoid arthritis. J Bone Joint Surg. 1992;74(6):903–9.

    Article  Google Scholar 

  31. Hobson SA, Karantana A, Dhar S. Total ankle replacement in patients with significant pre-operative deformity of the hindfoot. J Bone Joint Surg Br. 2009;91(4):481–6.

    Article  CAS  Google Scholar 

  32. Goldberg A, Zaidi R, Thomson C, Doré CJ, Skene SS, Cro S, Round J, Molloy A, Davies M, Karski M, Kim L, Cooke P, TARVA study group. Total ankle replacement versus arthrodesis (TARVA): protocol for a multicentre randomised controlled trial. BMJ Open. 2016;6(9):e012716. https://doi.org/10.1136/bmjopen-2016-012716.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Haddad SL, Coetzee JC, Estok R, et al. Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis. A systematic review of the literature. J Bone Joint Surg Am. 2007;89:1899–905.

    Article  CAS  Google Scholar 

  34. Saltzman CL, Mann RA, Ahrens JE, et al. Prospective controlled trial of STAR total ankle replacement versus ankle fusion: initial results. Foot Ankle Int. 2009;30(7):579–96.

    Article  Google Scholar 

  35. Daniels TR, Younger ASE, Penner M, et al. Intermediate-term results of total ankle replacement and ankle arthrodesis: a COFAS multicenter study. J Bone Joint Surg. 2014;96(2):135–42.

    Article  Google Scholar 

  36. Kim BS, Choi WJ, Kim YS, Lee JW. Total ankle replacement in moderate to severe varus deformity of the ankle. J Bone Joint Surg Br. 2009;91(9):1183–90.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The author wishes to thank Jennifer Anderson, M. D. for her support in the preparation of this chapter.

Author information

Authors and Affiliations

  1. University of Basel, Mein Fusszentum Basel, Basel, Switzerland

    Markus Knupp

Authors
  1. Markus Knupp
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Markus Knupp .

Editor information

Editors and Affiliations

  1. Orthopedic Surgery Department, Clínica Alemana de Santiago - Universidad del Desarrollo, Santiago, RM - Santiago, Chile

    Emilio Wagner Hitschfeld

  2. Orthopedic Surgery Department, Clínica Alemana de Santiago - Universidad del Desarrollo, Hospital Militar de Santiago – Universidad de los Andes, Santiago, RM - Santiago, Chile

    Pablo Wagner Hitschfeld

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Knupp, M. (2022). Diffuse Ankle Osteoarthritis. In: Wagner Hitschfeld, E., Wagner Hitschfeld, P. (eds) Foot and Ankle Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-95738-4_32

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-95738-4_32

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-95737-7

  • Online ISBN: 978-3-030-95738-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation