Ankle osteoarthritis (I): Joint preservation surgery

Abstract

The thinness of ankle articular cartilage and the small contact area, leading to high peak contact stresses, can make the joint more susceptible to posttraumatic osteoarthritis in cases of articular cartilage damage. 2. It appears that triamcinolone is more effective than betamethasone and methylprednisolone. 3. Despite the growing interest in stem cell transplantation for cartilage regeneration, knowledge on this topic is still preliminary. 4. Ankle arthroscopy for the treatment of ankle arthritis, excluding isolated bony impingement, is not particularly effective, and there is insufficient evidence-based literature to support the benefit of arthroscopy for the management of synovitis. 5. Supramalleolar osteotomy is ideally indicated for medial gutter ankle osteoarthritis (Takakura stage II or IIIA), but stage IIIB is also indicated in some select cases, where age can be an important factor. 6. Joint distraction with external fixation has evolved as an alternative treatment to natural joint-ablation non-preserving procedures such as ankle arthrodesis or total ankle replacement.