Scientists develop total ankle replacement

June 30th, 2008 - 4:39 pm ICT by IANS  

Washington, June 30 (IANS) Patients with acute arthritis can avail total ankle replacement that offers greater mobility and pain relief without metal implants. Pioneered by Daniel K. Lee, at University of California, it is the first to offer long-suffering arthritis patients a non-metallic, biological ankle replacement.

“Up until now, patients have had two options… metal implants or fusion of the joints,” said Lee, director of foot and ankle surgery at UC Medical Centre.

“Now there is an option that actually restores the ankle with an FDA-approved biologic material that is similar to the collagen found in cartilage.”

During a two-hour minimally invasive procedure, Lee, an ankle surgeon, removed the damaged cartilage around the ankle joint through a four centimetre incision.

The collagen material is then moulded into the joint where it adapts to the contour of the patient’s ankle.

“Unlike a metal device… this material can be customised in size and contour for every patient’s individual need,” said Lee. “No matter how the patient’s ankle is shaped, the collagen is a perfect fit.”

The biologic material, processed from either human or animal collagen sources, has been used for more than 10 years in plastic and abdominal surgery and heart valve replacement.

Since it is non-allergenic and sterile in nature, there is no risk of rejection or need for the patient to take immuno-supressors.

To allow the material to integrate fully with the ankle joint, a temporary external device is used to stabilise the joint area while keeping it “distracted” or open for a period of 4-6 weeks.

Attached by small pins, the cylinder-shaped device serves as a shock system to keep the joint free from friction and movement until healing is complete. The device is then removed entirely, which keeps the patient’s ankle free from any metal parts.

“Within three weeks after surgery, we see an incorporation of tissue onto the damaged cartilage,” said Lee. “The idea here is to avoid fusion of the ankle and to add longevity to the joint. We want to give patients as much mobility as possible so they can get back to the activities they love the most.”

Lee’s patients are aged between 30 and 85 years. Robert Adams, 82, a retired professor, received the ankle replacement after repeated attempts at physical therapy, reports Sciencedaily.

“My ankle collapsed on me,” said Adams. “I didn’t like the idea of a fusion with no motion or opening up my ankle for a metal device. Following this surgery, I no longer have sharp or stabbing pains. I am continuing to improve and can get around better.”

This novel technique will appear in a forthcoming edition of Journal of Foot & Ankle Surgery.

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