Saltzman Charles L, Alvine Frank G
Department of Orthopaedic Surgery, Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa, USA.
Instr Course Lect. 2002;51:129-33.
The Agility Total Ankle System can be used in most arthritic conditions that involve the ankle joint, including many angular deformities that result from trauma or degenerative wear. The surgeon must be prepared to realign the ankle and to achieve soft-tissue balancing at the time of the surgery to avoid late failures. Proper patient selection is very important, and certain conditions, including diabetes with peripheral neuropathy, poor skin quality or poor circulation, and deficient bone stock, must be avoided to achieve a successful outcome. The surgical procedure must be done in a precise manner, with selection of the proper size of prosthesis and accurate insertion of the components in all directions. Proper tensioning of the joint is also paramount to achieve long-term stability. The precise degree of tensioning is still somewhat controversial, although with experience the deltoid end point can be readily determined in most patients. The follow-up care of these patients is very important, not only from the standpoint of compliance but also because any long-term problems must be recognized and treated before the implant is lost.
敏捷全踝关节系统可用于大多数累及踝关节的关节炎病症，包括许多由创伤或退行性磨损导致的角形畸形。外科医生在手术时必须准备好重新调整踝关节并实现软组织平衡，以避免后期失败。正确选择患者非常重要，必须避免某些病症，包括伴有周围神经病变的糖尿病、皮肤质量差或循环不良以及骨量不足，以获得成功的结果。手术过程必须精确进行，选择合适尺寸的假体并将组件精确地全方位插入。关节的适当张紧对于实现长期稳定性也至关重要。尽管凭借经验在大多数患者中可以很容易地确定三角肌终点，但精确的张紧程度仍存在一定争议。这些患者的随访护理非常重要，不仅从依从性的角度来看如此，还因为任何长期问题必须在植入物丢失之前得到识别和治疗。
