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经外侧腓骨入路行全踝关节置换治疗踝关节骨关节炎

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach.

作者信息

Usuelli Federico G, D'Ambrosi Riccardo, Manzi Luigi, Maccario Camilla, Indino Cristian

机构信息

Galeazzi Orthopedic Institute for Research and Care;

Galeazzi Orthopedic Institute for Research and Care; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano.

出版信息

J Vis Exp. 2018 Jan 24(131):56396. doi: 10.3791/56396.

Abstract

Total ankle replacement (TAR) is a valid option for the treatment of ankle osteoarthritis. The traditional surgical approach for TAR is the anterior approach. Recently, the lateral transfibular approach to the ankle has gained popularity since a new TAR implant was designed to be performed via this approach that results in an ideal visualization of the center of rotation of the ankle and curved resections that allow for sparing bone cuts. The aim of the present paper is to present our preoperative, operative, and postoperative protocols for the treatment of the osteoarthritis of the ankle with TAR via lateral approach. We present our preoperative clinical and radiographic protocol. In addition, we describe our surgical technique with some technical tips. Finally, we report our follow-up schedule that includes the collection of clinical, functional, and radiographic data. The results of this procedure are encouraging: TAR through a lateral transfibular approach provides reliable pain relief and improvements in functional outcomes in patients with ankle osteoarthritis.

摘要

全踝关节置换术(TAR)是治疗踝关节骨关节炎的一种有效选择。TAR的传统手术入路是前侧入路。最近,经腓骨外侧入路治疗踝关节越来越受欢迎,因为一种新的TAR植入物设计为通过该入路进行,可实现踝关节旋转中心的理想可视化以及弧形截骨,从而减少骨质切除。本文旨在介绍我们采用外侧入路行TAR治疗踝关节骨关节炎的术前、术中及术后方案。我们展示了术前的临床和影像学方案。此外,我们描述了手术技术及一些技术要点。最后,我们报告了随访计划,包括临床、功能和影像学数据的收集。该手术的结果令人鼓舞:经腓骨外侧入路的TAR为踝关节骨关节炎患者提供了可靠的疼痛缓解并改善了功能结局。

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