Medial impingement after ankle replacement

Ankle replacements appear to offer a good alternative to fusion for most arthritic conditions. Use of mobile bearings has significantly improved results of ankle replacement. Ankle replacements still have a significant minor-complication rate which does not seem to affect the long-term outcome. Medial impingement as a complication has been reported with popular designs. We reviewed the senior author's first five years of Buechel-Pappas ankle replacements looking at AOFAS scores, VAS scores, patient satisfaction, learning curve of the surgeon and complications. Eight patients out of a total of 34 reported symptoms of medial impingement at follow-up. Four patients underwent revision surgery for this. Ankle replacements have a significant proportion of minor complications, one of which is medial impingement. Whether this is due to implant design, residual arthritis in medial recess or soft-tissue pathology is uncertain but revision surgery may be required.