Bonasia Davide Edoardo, Dettoni Federico, Femino John E, Phisitkul Phinit, Germano Margherita, Amendola Annunziato
Mauriziano Umberto I Hospital, Department of Orthopaedics and Traumatology, University of Torino Medical School, Largo Turati 62, 10128, Torino, Italy.
Iowa Orthop J. 2010;30:119-30.
Total ankle replacement (TAR) was first attempted in the 1970s, but poor results led to its being considered inferior to ankle fusion until the late 1980s and early 1990s. By that time, newer designs which more closely replicated the natural anatomy of the ankle, showed improved clinical outcomes. Currently, even though controversy still exists about the effectiveness of TAR compared to ankle fusion, TAR has shown promising mid-term results and should no longer be considered an experimental procedure. Factors related to improved TAR outcomes include: 1) better patient selection, 2) more precise knowledge and replication of ankle biomechanics, 3) the introduction of less-constrained designs with reduced bone resection and no need for cementation, and 4) greater awareness of soft-tissue balance and component alignment. When TAR is performed, a thorough knowledge of ankle anatomy, pathologic anatomy and biomechanics is needed along with a careful pre-operative plan. These are fundamental in obtaining durable and predictable outcomes. The aim of this paper is to outline these aspects through a literature review.
全踝关节置换术（TAR）最早于20世纪70年代尝试，但由于效果不佳，直到20世纪80年代末和90年代初，它一直被认为不如踝关节融合术。到那时，更接近踝关节自然解剖结构的新设计显示出了更好的临床效果。目前，尽管与踝关节融合术相比，TAR的有效性仍存在争议，但TAR已显示出有希望的中期结果，不应再被视为一种实验性手术。与TAR效果改善相关的因素包括：1）更好的患者选择；2）对踝关节生物力学更精确的了解和复制；3）引入了约束性较小的设计，减少了骨切除且无需骨水泥固定；4）对软组织平衡和假体对线的认识提高。进行TAR时，需要对踝关节解剖、病理解剖和生物力学有透彻的了解，并制定仔细的术前计划。这些对于获得持久且可预测的结果至关重要。本文旨在通过文献综述概述这些方面。
