Duke University Medical Center, Durham, North Carolina.
J Surg Orthop Adv. 2020 Winter;29(4):244-248.
Avascular necrosis (AVN) of the talus remains a clinical challenge with suboptimal outcomes after treatment. In cases of extensive disease, the insufficient blood supply leads to a high rate of complications including non-union after surgical treatment. This, in conjunction with the development of premature adjacent arthritis represents a challenge for the treating surgeon. Nowadays, total ankle arthroplasty is a reasonable option for the treatment of end-stage ankle arthritis with improved short- and long-term outcomes. We present a technique for patients with end-stage ankle arthritis associated to extensive talar osteonecrosis, and patients with prior total ankle replacement and talar component collapse due to AVN. This technique provides a more anatomic treatment for patients with severely deficient bone stock due to talar necrosis with ankle arthritis or failed ankle replacement. Nonetheless, evaluation of the outcomes at long-term is needed. (Journal of Surgical Orthopaedic Advances 29(4):244-248, 2020).
距骨坏死（AVN）仍然是临床挑战，治疗后效果不佳。在广泛疾病的情况下，由于血液供应不足，导致包括手术后非愈合在内的并发症发生率很高。这与相邻关节炎的早期发展一起，对治疗外科医生构成了挑战。如今，全踝关节置换术是治疗终末期踝关节关节炎的合理选择，可改善短期和长期结果。我们为患有终末期踝关节关节炎和广泛距骨骨坏死的患者以及因 AVN 而导致全踝关节置换和距骨组件塌陷的患者提供了一种技术。对于因距骨坏死导致踝关节关节炎或踝关节置换失败而严重骨质流失的患者，该技术为其提供了更具解剖学意义的治疗方法。然而，需要对长期结果进行评估。（《外科矫形进展杂志》29（4）：244-248，2020）。
