Posterior Talar Shifting in Mobile-Bearing Total Ankle Replacement

Foot Ankle Int. 2016 Mar;37(3):281-7. doi: 10.1177/1071100715610426. Epub 2015 Oct 6.


Background: End-stage ankle osteoarthritis frequently involves multiplanar malalignment in both the coronal and the sagittal planes. Sagittal malalignment often includes anterior translation of the talus relative to the tibia. Restoration of the correct tibial and talar alignment is essential for the long-term survival of total ankle replacement.

Methods: This study includes 66 consecutive patients who underwent total ankle arthroplasty with the Hintegra prosthesis from May 2011 to April 2014. There were 28 females (42.4%) and 38 males (57.6%) with a mean age of about 57 years (25-82 years). Patients were clinically and radiologically assessed preoperatively and at 2, 6, and 12 months postoperatively.

Results: At 12 months postoperatively, there was a statistically significant increase in American Orthopaedic Foot & Ankle Society scores from 31.9 to 72.3. Range of motion significantly increased from 9.5 to 25.4 degrees. In addition, there was a statistically significant decrease in visual analog scale (VAS) pain score from 8.9 to 2.2. Furthermore, there was a significant increase in the Tibio-Talar ratio from 2 to 6 months postoperatively (34.6%-37.2%).

Conclusions: This study demonstrated significant improvements in clinical and radiologic outcomes after Hintegra total ankle arthroplasty. Significant movement of the talus occurs within the first 6 months postoperatively. This may be the result of rebalancing of muscle and ligament forces after surgery.

Level of evidence: Level IV, case series.

Keywords: anterior translation; mobile bearing; osteoarthritis; posterior translation; talus; total ankle arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ankle Joint / diagnostic imaging
  • Ankle Joint / surgery
  • Arthroplasty, Replacement, Ankle*
  • Female
  • Humans
  • Joint Prosthesis*
  • Male
  • Middle Aged
  • Osteoarthritis / surgery
  • Range of Motion, Articular
  • Talus / diagnostic imaging*
  • Tibia / diagnostic imaging*
  • Visual Analog Scale