Tanaka Y, Takakura Y
Department of Ortopaedic Surgery, Nara Medical University, Nara 634-8522, Kashihara, Japan.
Orthopade. 2006 May;35(5):546-51. doi: 10.1007/s00132-006-0942-x.
Total ankle replacement has been introduced in the last 30 years. The TNK ankle is build from ceramics, and it was continuously improved. This prosthesis has the longest fellow-up times. Seventy ankle prostheses of the newest generation has been implanted between 1991 and 2001. Of these, 67 prostheses were assessed clinically and radiographically after 62 months (range, 24 to 132 months). Three ankles have been revised. The clinical score improved for the patients with primary or posttraumatic arthritis from 34 to 86, and for the patients with rheumatoid arthritis from 45 to 74. Loosening was found in 4 ankles with non-rheumatoid arthritis, and in 17 ankles with rheumatoid ankles. Total ankle replacement has emerged to a valuable alternative to ankle arthrodesis, and satisfactory results have been achieved with the current implants. The bone-implant interphase might play a most important factor for success. There is evidence that the biologic advantages of ceramics may help to improve long-lasting success in total ankle replacement.
全踝关节置换术在过去30年中已被引入。TNK踝关节由陶瓷制成，并不断改进。这种假体的随访时间最长。1991年至2001年间植入了70个最新一代的踝关节假体。其中，67个假体在62个月（范围为24至132个月）后进行了临床和影像学评估。有3个踝关节进行了翻修。原发性或创伤后关节炎患者的临床评分从34提高到86，类风湿性关节炎患者的临床评分从45提高到74。在4个非类风湿性关节炎踝关节和17个类风湿性踝关节中发现了松动。全踝关节置换术已成为踝关节融合术的一种有价值的替代方法，并且目前的植入物已取得了满意的结果。骨-植入物界面可能是成功的最重要因素。有证据表明，陶瓷的生物学优势可能有助于提高全踝关节置换术的长期成功率。
