Clinic of Orthopaedic Surgery, Kantonsspital, Rheinstrasse 26, CH-4410 Liestal, Switzerland.
Foot Ankle Int. 2010 Sep;31(9):754-9. doi: 10.3113/FAI.2010.0754.
Total ankle replacement has become a valuable treatment option for end-stage osteoarthritis. The most recent generation of implants comprises a second interface between the polyethylene insert and the tibial prosthetic component. This may permit a better adaptation of position between the implant components and thereby prevent unphysiological loading of ankle ligaments and reduce polyethylene wear. To date, no available data have evaluated whether the relative position of talar and tibial implant components change over time.
We assessed the radiographs of 368 ankles that underwent primary arthroplasty with a HINTEGRA® (Newdeal SA, Lyon, France / Integra, Plainsboro, NJ) ankle to determine the spatial relationship between talar and tibial components at the time of surgery and during followup. The mean time to final followup was 51.2 months (range 11 to 98). We analyzed the anteroposterior offset as the distance between the center of the tibiotalar joint and the longitudinal axis of the tibia.
The mean anteroposterior offset ratio was 0.0 ± 0.06 (range -0.21 to 0.16), and it remained constant over time.
Our data suggest that the latest three-component prosthesis functions similar to the two-component prosthesis, but we believe with an added advantage of allowing an individualized position of the polyethylene insert in response to the individual soft tissue load due to different ankle joint configurations.
全踝关节置换术已成为治疗终末期骨关节炎的一种有价值的治疗选择。最新一代的植入物在聚乙烯插入物和胫骨假体组件之间有第二个界面。这可能允许植入物组件之间的位置更好地适应，从而防止踝关节韧带的非生理性负荷并减少聚乙烯磨损。迄今为止，尚无可用数据评估距骨和胫骨植入物组件的相对位置是否随时间而变化。
我们评估了 368 例接受 HINTEGRA®（法国里昂 Newdeal SA/美国普林斯顿 Integra）踝关节初次置换的踝关节的 X 光片，以确定手术时和随访时距骨和胫骨组件之间的空间关系。最终随访的平均时间为 51.2 个月（范围为 11 至 98 个月）。我们分析了前后偏移量，即距骨关节中心与胫骨长轴之间的距离。
平均前后偏移比为 0.0 ± 0.06（范围为-0.21 至 0.16），并且随着时间的推移保持不变。
我们的数据表明，最新的三组件假体的功能类似于两组件假体，但我们认为，由于踝关节结构的不同，它具有允许根据个体软组织负荷来个性化调整聚乙烯插入物位置的额外优势。
