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Published on : Jan 14, 2020 | Views : 1267 | Downloads : 3

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Slide 1-

Artificial Ankle Replacement
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Outlines 2 History Anatomy Ankle movement Artificial ankle and types Operation Conclusion Development
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What is artificial ankle replacement ? 3 Ankle replacement surgery is the replacement of a damaged ankle joint with an artificial implant. Arthritis can affect this joint as well as other joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away. This can result in pain, inflammation, and swelling of your joint.
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History 4 Previously the patient only had one option and that was to fuse the ankle joint. This meant a permanent loss of function in the up/down movement of this joint. The benefit to the patient was that they were no longer in pain. This used to be tolerated by the patient because by the time they would contemplate such a major intervention they had lost a great deal of their movement anyway.
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History (cont.) 5 Ankle replacement is a newer option. The procedure, also known as ankle arthroplasty, replaces the arthritic ankle joint with a metal and plastic prosthesis. The recovery period is shorter than ankle fusion – typically three to six weeks in a cast followed by physical therapy. People regain a much wider range of motion; most return to active lifestyles. While the artificial ankle can wear out and may need to be replaced, research shows 90 percent are still functioning well 10 years after surgery.
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Anatomy 6 The human ankle joint is a connection between the foot and lower leg. The ankle includes two joints: The upper ankle joint (tibiotarsal articulation) The lower ankle joint (talotarsal articulation) This joint primarily produces dorsiflexion and plantar flexion of the foot, as well as the pronation and supination under certain degree. Since the joint handles great mechanical burden, it is prone to injuries that can affect both bones and the ligaments of the joint.
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Anatomy (cont.) 7 Upper ankle joint The upper ankle joint is a hinge joint. Its main task is to enable dorsiflexion (stretching) and plantar flexion (bending). The upper ankle joint is composed of the three bones: fibula (calf bone) tibia (shin bone) talus (ankle bone)
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Anatomy (cont.) 8 Lower ankle joint: The bony anatomy of the lower ankle joint (LAJ) is less complex as it basically consists of three parts. The following bones form the lower ankle joint: talus (ankle bone). calcaneus (heel bone). navicular bone.
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Ankle movement 9 The front part of the lower ankle joint is an articulation between talus, calcaneus and navicular bone. The back part of the lower ankle joint is an articulation between talus and calcaneus and is called subtler joint.
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Ankle movement (cont.) 10 The lower ankle joint permits two movements: pronation and supination of the foot The upper ankle joint permits the dorsiflexion and plantar flexion. The ankle joint allows up-and-down movement of the foot. The subtler joint sits below the ankle joint, and allows side-to-side motion of the foot. Numerous ligaments (made of tough, moveable tissue) surround the true ankle and subtler joints, binding the bones of the leg to each other and to those of the foot.
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Ankle movement (cont.) 11 Lower joint movement Upper joint movement
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Ankle conditions 12 Sprained ankle: Damage to one of the ligaments in the ankle, usually from an accidental twist or turn of the foot. Rehabilitation can prevent pain and swelling from becoming a long-term problem. Ankle fracture: A break in any of the three bones in the ankle. Most commonly, the bones of the lower leg (tibia or fibula) is fractured. Rheumatoid arthritis: An autoimmune form of arthritis in which the body attacks joint tissue, causing inflammation, pain, and swelling.
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Artificial ankle 13 Each artificial ankle prosthesis is made of two parts: The tibial component is the part of the artificial joint that replaces the socket portion of the ankle (the top section). The talus component replaces the top of the talus. The tibial component is usually made up of two parts: A flat metal piece called a metal tray that is attached directly to the tibia bone, and a plastic cup that fits onto the metal piece, forming a socket for the artificial ankle joint. The talus component is made of metal and fits into the socket of the tibial component.
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Artificial ankle (cont.) 14 Cemented prosthesis is a special type of epoxy cement that attach the metal components to the bone. Uncemented prosthesis is type that the surface is a fine mesh of holes that allow bone to grow into the mesh and attach the prosthesis to the bone.
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Types of artificial ankle 15 The Agility Ankle: The Agility Ankle is designed to be used with bone cement. The INBONE Total Ankle: The modular design of the INBONE™ Total Ankle allows the physician to select the appropriate components based on patient size and bone structure.
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Types of artificial ankle (cont.) 16 Salto Talaris Anatomic Ankle: The Salto Talaris mimics the anatomy and flexion/extension movements of the natural ankle joint. The STAR (Scandinavian Total Ankle Replacement): STAR’s modular components allow matched configurations with just one surgical technique. While rotating across the axial plane.
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The operation 17 Before surgery you will be placed under either general anesthesia or a spinal type of anesthesia. The surgeon begins the operation by making an incision through the skin on the front of the ankle. The surgeon opens the joint to prepare the surfaces to be replaced.
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The operation (cont.) 18 To fit the metal socket in place, the ends of the ankle bones are shaped. The tibia and fibula are shaped first. The top of the talus is shaped so the metal talus component can be inserted. All the different pieces of the artificial ankle joint are put in place, and the ankle is tested to make sure the pieces fit properly.
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The operation 19 To make sure that the ankle socket or the tibial component fits tightly; two screws are placed through the fibula and the tibia just above the artificial ankle joint. Bone is grafted between the fibula and tibia to create a fusion between them. This stops any motion between the two bones that could loosen the artificial joint. The bone graft is taken from the bone that was removed from the ankle earlier during the shaping procedure.
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The operation (cont.) 20 1 2 3
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Complications 21 Some of the most common complications following artificial ankle replacement are: anesthesia infection loosening nerve injury
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After Surgery 22 Your ankle will probably be placed in a cast or splint after surgery. A small plastic tube may drain blood from the joint. Draining prevents excessive swelling from the blood. The draining tube will likely be removed within the first day. The surgeon will want to check your ankle within five to seven days. Stitches will be removed after 10 to 14 days, although most of them will have been absorbed into your body. Your surgeon can give you medication to control any pain. You should keep your ankle elevated above the level of your heart for several days to avoid swelling and throbbing. Keep it propped up on a stack of pillows when sleeping or sitting.
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Conclusion 23 The average cost for an ankle replacement surgery in the United States is $23,936, though prices can range from $14,730 to $40,507. Ankle replacement surgery is a procedure to replace this damaged joint to eliminate this pain and swelling. The ankle joint engages with almost every movement you make it’s even involved when you’re just standing still. When it’s working well, you don’t think about the mechanics of your ankle.
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Development 24 Using tissue engineering technique of ankle cartilage
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25 https://youtu.be/q49dI-kZQxs Total Ankle Replacement
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Any Questions ? 26