Midterm Results of Ankle Distraction Arthroplasty as a Salvage Option for Ankle Osteoarthritis in Young Patients: A Retrospective Cohort Study

surfaces by applying an external fixator and distracting the joint.In doing so, the mechanical overload on the cartilage is relieved, allowing reparative processes to take place.Additionally, the frame allows the patient to bear weight, causing cyclical fluctuations in the intra-articular hydrostatic pressures, thereby improving IntroductIonAnkle osteoarthritis (OA) is a slowly progressive, degenerative joint disorder that is often diagnosed late due to the delayed onset of clinical symptoms. 1Several etiological factors have been implicated in the development of OA in young individuals; however, highenergy trauma, as seen in trimalleolar or tibial plafond fractures, and recurrent ligamentous instability remain the foremost contributory factors. 2 Since patients with posttraumatic ankle OA present at a much younger age, as compared to hip and knee joint OA, jointpreserving surgeries are highly desirable to improve the quality of life, delay the disease progression, and defer or circumvent the need for joint-sacrificing procedures. 3,4Total ankle arthroplasty (TAA) and ankle arthrodesis relieve pain and provide good short-term results. 5However, both are associated with potential complications such as increased stresses on adjacent joints; leading to degeneration; increased energy expenditure; malunion and nonunion with TAA; and wear, failure, and subsequent revisions with ankle fusion. 6,7nkle distraction arthroplasty (ADA) has gradually gained acceptance and recognition as a lucrative joint-preserving option, dramatically reducing pain and improving ankle function, thereby obviating the need or delaying the time to arthroplasty or fusion. 8The goal of the procedure is to increase the joint space and refurbish the articulating 1,