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Author: Victor Valderrabano x

Foot & Ankle x

Ankle osteoarthritis: comprehensive review and treatment algorithm proposal

Mario Herrera-Pérez

Mario Herrera-Pérez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
Department of Surgery, Universidad de La Laguna, Tenerife, Spain

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Victor Valderrabano

Victor Valderrabano Foot and Ankle Unit, Orthopaedic Department, Schmerzklinik, Basel, Switzerland
University of Basel, Basel, Switzerland

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Alexandre L Godoy-Santos

Alexandre L Godoy-Santos Orthopaedic Department, Hospital Israelita, Sao Paulo, Brazil

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César de César Netto

César de César Netto Director of the UIOWA Orthopedic Functional Imaging Research Laboratory (OFIRL), Iowa, USA
Department of Orthopedic and Rehabilitation, University of Iowa, Iowa, USA

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David González-Martín

David González-Martín Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
Department of Surgery, Universidad de La Laguna, Tenerife, Spain

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Sergio Tejero

Sergio Tejero Foot and Ankle Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
Department of Surgery, Universidad de Sevilla, Sevilla, Spain

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Ankle osteoarthritis (OA) is much less frequent than knee or hip OA, but it can be equally disabling, greatly affecting the quality of life of the patients.
Approximately 80% of ankle OA is post-traumatic, mainly secondary to malleolar fractures, being another of the main causes untreated in chronic instability. The average age of the patient affected by ankle OA is around 50 years, being therefore active patients and in working age who seek to maintain mobility and remain active.
The authors conducted a comprehensive review of the conservative, medical, and surgical treatment of ankle OA.
Initial conservative treatment is effective and should be attempted in any stage of OA. From a pharmacological point of view, non-steroidal anti-inflammatory drugs (NSAIDs) and intra-articular infiltrations can produce temporary relief of symptoms.
After the failure of conservative-medical treatment, two large groups of surgical treatment have been described: joint-preserving and joint-sacrificing procedures.
In the early stages, only periarticular osteotomies have enough evidence to recommend in ankle OA with malalignment. Both ankle arthrodesis and ankle replacement can produce satisfactory functional results if correctly indicated in the final stages of the disease.
Finally, the authors propose a global treatment algorithm that can aid in the decision-making process.