Joint Distraction in Advanced Osteoarthritis of the Ankle



Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain


replacement (TAR) in patients with advanced ankle osteoarthritis (OA). AJD could a tenable option to ankle fusion or
Methods: A review has been performed on the role of AJD in advanced OA of the ankle. The exploration machine
was MedLine. The keywords utilized were: joint distraction ankle. Three hundred and eleven articles were found. Of
the above-mentioned, only 14 were chosen and analyzed because they were rigorously focused on the issue and the
question of this paper.
Results: Forty-seven patients met inclusion criteria with 15 in the acute RSA group and 32 in the secondary RSA group.
The acute RSA group demonstrated better external rotation (28˚) than the secondary RSA group (18˚, P=0.0495). The
acute RSA group showed a trend towards better Single Assessment Numeric Evaluation (SANE) scores. Tuberosity
healing rate was higher in the acute RSA group.
Conclusion: The types of articles published until now have a poor level of evidence (levels III and IV). The overall
number of patients managed until now by way of AJD is 249. The published mean follow-up is very variable, from 1
year to 12 years. The rate of good outcomes ranged between 73% and 91%. The percentage of failure (final ankle
arthrodesis or TAR) ranged between 6.2% and 44%. A minimum of 5.8 mm of distraction gap must be achieved. Ankle
function after AJD deteriorates over time. Putting together ankle movement and distraction will result in an early and
maintained profitable influence on outcome.


Main Subjects