Arthroscopic debridement: effective treatment for impingement after total ankle arthroplasty

  • Andrew B. Richardson
  • James K. DeOrio
  • Selene G. ParekhEmail author
Foot and Ankle (DE Bonasia and P Phisitkul, Section Editors)


Total ankle arthroplasty has been gaining significant popularity for the treatment of ankle arthritis. Subsequent rates of revision surgery secondary to symptomatic bony impingement have been reported in 6–45 % of cases. Arthroscopic debridement of bony impingement following total ankle has been recently reported as an effective therapy. An arthroscopic technique has been recently published by one of the senior authors. In this paper, we expand this technique and retrospectively review our experience with arthroscopic debridement of twenty ankles in twenty patients with symptomatic bony impingement following total ankle arthroplasty.


Ankle arthroplasty Arthroscopic Impingement Heterotopic Ossification Foot Ankle 



No conflicts of interest relevant to this article were reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    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.PubMedCrossRefGoogle Scholar
  2. 2.
    Saltzman CL, Kadoko RG, Suh JS. Treatment of isolated ankle osteoarthritis with arthrodesis or the total ankle replacement: a comparison of early outcomes. Clinics in Orthopedic Surgery. 2010;2(1):1–7.PubMedCrossRefGoogle Scholar
  3. 3.
    SooHoo NF, Zingmond DS, Ko CY. Comparison of reoperation rates following ankle arthrodesis and total ankle arthroplasty. J Bone Joint Surg Am. 2007;89(10):2143–9.PubMedCrossRefGoogle Scholar
  4. 4.
    • Mann JA, Mann RA, Horton E.: STAR (TM) Ankle: Long-Term Results. Foot Ankle Int. 2011;32(5):473-484. This study reports the first U.S. prospective long-term survivorship data with the STAR™ Ankle prosthesis, describing long term outcome data and complications following total ankle replacement and found it to be an excellent long-term option for the treatment of ankle arthritis.CrossRefGoogle Scholar
  5. 5.
    • Easley ME, Adams SB, Hembree WC, et al.: Results of Total Ankle Arthroplasty. J Bone Joint Surg Am. 2011;93A(15):1455-1468. This study perfomed a large meta-analysis of the current literature regarding long -term surviorship data on total ankle replacement and shows that comparative studies with a fair to good-quality level of evidence suggest that total ankle arthroplasty provides equal pain relief and possibly improved function compared with ankle arthrodesis. This article addionally reports the outcomes and complications from many of the current ankle arthroplasty impants available.CrossRefGoogle Scholar
  6. 6.
    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;89A(9):1899–905.CrossRefGoogle Scholar
  7. 7.
    Pyevich MT, Saltzman CL, Callaghan JJ, et al. Total ankle arthroplasty: a unique design - Two to twelve-year follow-up. J Bone Joint Surg Am. 1998;80A(10):1410–20.Google Scholar
  8. 8.
    Spirt AA, Assal M, Hansen ST. Complications and failure after total ankle arthroplasty. J Bone Joint Surg Am. 2004;86A(6):1172–8.Google Scholar
  9. 9.
    Kopp FJ, Patel MM, Deland JT, et al. Total ankle arthroplasty with the agility prosthesis: Clinical and radiographic evaluation. Foot Ankle Int. 2006;27(2):97–103.PubMedGoogle Scholar
  10. 10.
    Knecht SI, Estin M, Callaghan JJ, et al. The agility total ankle arthroplasty - Seven to sixteen-year follow-up. J Bone Joint Surg Am. 2004;86A(6):1161–71.Google Scholar
  11. 11.
    Rippstein PF, Huber M, Coetzee C, et al. Total ankle replacement with use of a new three-component implant. J Bone Joint Surg Am. 2011;93A(15):1426–35.CrossRefGoogle Scholar
  12. 12.
    • Lee KB, Cho YJ, Park JKet al.: Heterotopic Ossification After Primary Total Ankle Arthroplasty. J Bone Joint Surg Am. 2011;93A(8):751-758. This study demonstrates that the prevalence of heterotopic ossification following primary total ankle arthroplasty is considerable and that the presence of heterotopic ossification and can have significant impact on post-operative outcomes.CrossRefGoogle Scholar
  13. 13.
    Hintermann B, Valderrabano V, Dereymaeker G, et al. The HINTEGRA ankle: Rationale and short-term results of 122 consecutive ankles. Clin Orthop. 2004;424:57–68.PubMedCrossRefGoogle Scholar
  14. 14.
    Kurup HV, Taylor GR. Medial impingement after ankle replacement. Int Orthop. 2008;32(2):243–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Shirzad K, Viens NA, DeOrio JK. Arthroscopic treatment of impingement after total ankle arthroplasty: technique tip. Foot Ankle Int. 2011;32(7):727–9.PubMedCrossRefGoogle Scholar
  16. 16.
    Scranton PE, Mcdermott JE. Anterior tibiotalar spurs - a comparison of open versus arthroscopic debridement. Foot Ankle. 1992;13(3):125–9.PubMedGoogle Scholar
  17. 17.
    Ferkel RD, Scranton PE. Arthroscopy of the Ankle and Foot. J Bone and Joint Surg Am. 1993;75A(8):1233–42.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Andrew B. Richardson
    • 1
  • James K. DeOrio
    • 2
  • Selene G. Parekh
    • 3
    Email author
  1. 1.Department of Orthopaedic SurgeryDuke University Medical Center, DUMCDurhamUSA
  2. 2.Department of Orthopaedic SurgeryDuke University Medical CenterDurhamUSA
  3. 3.Department of Orthopaedic SurgeryDuke University Medical CenterDurhamUSA

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