摘要目的:分析50岁及以下的终末期踝关节炎患者应用INBONE Ⅱ假体行全踝关节置换术（TAA）的疗效。方法:回顾性分析2016年9月至2021年8月首都医科大学附属北京积水潭医院足踝外科因终末期踝关节炎使用INBONE Ⅱ假体行TAA的28例较年轻患者资料。年龄（46.0±4.0）岁；男12例，女16例；体重指数（24.9±3.3）kg/m 2。比较患者术前、末次随访时的胫骨关节面（TAS）角、距骨倾斜（TT）角、胫距关节面（TLS）角、踝关节跖屈角度、踝关节背伸角度、踝关节活动范围、美国足踝外科协会（AOFAS）踝-后足评分、健康调查简表（SF-36）、足功能指数（FFI）、疼痛视觉模拟评分（VAS），记录5点Likert量表患者满意度、术后并发症的发生情况等。 结果:所有患者术后随访（49.8±15.3）个月。除TAS角及踝关节跖屈角度外，所有患者末次随访时TT角[0.4°（0,0.6°）]、FFI[20.0（7.3,48.0）分]、疼痛VAS评分[2.0（1.0，2.8）分]较术前[1.6°（0.3°,4.4°）、（99.9±40.6）分、6.0（4.0，6.8）分]显著降低，TLS角（86.3°±2.8°）、踝关节背伸角度（13.5°±5.4°）、踝关节活动范围（34.7°±7.9°）、AOFAS踝-后足评分[82.0（74.0，89.0）分]、SF-36评分[122.5（112.8,130.2）分]均较术前[78.9°±5.7°、10.3°±8.0°、31.1°±12.0°、（49.9±3.2）分、97.7（89.8,101.6）分]显著增加，差异均有统计学意义（ P<0.05）；末次随访时患者满意率为89.3%（25/28）。所有患者均未发生严重术后并发症，未行二次翻修手术。 结论:50岁及以下的终末期踝关节炎患者应用INBONE Ⅱ假体行TAA的临床改善效果及满意度良好，应用该方法的患者年龄可能不应该局限于50岁以上。

abstractsObjective:To analyze the clinical outcomes of total ankle arthroplasty (TAA) using the INBONE Ⅱ prosthesis in patients ≤50 years old with end-stage ankle arthritis.Methods:A retrospective analysis was conducted of the consecutive patients who had undergone TAA using the INBONE Ⅱ prosthesis between September, 2016 and August, 2021 at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital, Capital Medical University. There were 12 males and 16 females with an age of (46.0±4.0) years and a body mass index of (24.9±3.3) kg/m 2. The clinical outcomes recorded and compared between pre-surgery and the last follow-up were tibial articular surface (TAS) angle, talar tilt (TT) angle, tibial lateral surface (TLS) angle, ankle plantarflexion angle, ankle dorsiflexion, ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, MOS item short form health survey (SF-36), foot function index (FFI), and visual analog scale (VAS) for pain. Patient satisfaction by 5-point Likert scale and complications were recorded. Results:All patients were followed up for (49.8±15.3) months. Except for plantar flexion and TAS, for all patients at the last follow-up, TT angle [0.4° (0, 0.6°)], FFI [20.0 (7.3, 48.0) points], and VAS pain score [2.0 (1.0, 2.8) points] were significantly reduced compared with the preoperative values [1.6° (0.3°, 4.4°), (99.9±40.6) points, and 6.0 (4.0, 6.8) points], while TLS angle (86.3°±2.8°), ankle dorsiflexion (13.5°±5.4°), ankle ROM (34.7°±7.9°), AOFAS ankle-hindfoot score [82.0 (74.0, 89.0) points], and SF-36 score [122.5 (112.8, 130.2) points] were all significantly higher than the preoperative values [78.9°±5.7°, 10.3°±8.0°, 31.1°±12.0°, (49.9±3.2) points, and 97.7(89.8, 101.6) points] (all P<0.05). The rate of patient satisfaction at the last follow-up was 89.3% (25/28). No serious postoperative complications occurred and no revision surgery was required. Conclusion:TAA using the INBONE Ⅱ prosthesis has shown good clinical outcomes and a high rate of patient satisfaction in younger patients ≤50 years old with end-stage ankle arthritis.