Biomedical Engineering Reference
In-Depth Information
4.6.5.4 Authors' Insights
Osteolytic cysts can compromise the bony integrity of an ankle replacement (as
seen in this case). Early intervention with bone grafting and bearing exchange to a
more durable highly-cross-linked polyethylene can allow retention of well-fixed
components, restore function and minimize future osteolysis.
4.6.6 Case Report #6
Sliding-Cylindrical Total Ankle, Mark II with major revision to a custom
calcaneal component (Anatomic deep-sulcus design for use with intact malleoli
and functioning or reconstructable collateral ligaments).
4.6.6.1 History
A 61 year old, 220 pound (99 kg), 5 foot 11 inch (180 cm) tall, white male
hospital carpenter and maintenance mechanic developed intractable weight
bearing pain with crepitus and limited range of motion in his right ankle (10
o
dorsiflexion and 30
o
plantarflexion) over a one year period with no known history
of trauma. His hindfoot alignment was neutral, and he had good collateral
ligament stability. Pre-operative X-rays revealed advanced osteoarthritis of the
right tibio-talar joint with complete joint space loss, osteophyte formation and
minor boney ossicles in the medial deltoid ligament, see Fig. 4.53.
Fig. 4.53
AP, mortise and flexion-extension X-rays of an osteoarthritic right ankle in a 61
year old man with intractable pain and limited range of motion
