Access Keys:
Skip to content (Access Key - 0)

ESKA Ankle Prosthesis

The ESKA TAR is a non-constrained, fixed-bearing, two-component prosthesis that was designed in Germany for cementless implantation between 1985 and 1989.1,2  It has a shallow groove on the talar component that is congrous to the ultra-high-molecular-weight polyethylene (UHMWPE) bearing fixed to the tibial prosthesis.  The following features were included to improve the biomechanics of the ankle replacement:

  • Cementless implantation and porous-structured implant surface for faster osteointegration
  • Shear force reduction and rotational force control by shape design of both metallic components
  • Easy replacement of the polyethylene without disturbing prosthesis anchoring.1,2

Because of the ridge-like shaping and its transverse anchoring peg in both metallic components, a lateral approach with fibular osteotomy or in special cases, a medial malleolar approach is used for component implantation.3

In 2001, the prosthesis designer, Dr. Rudigier, published short-term results of 56 patients treated with the ESKA prosthesis since 1990.4  Forty of 56 patients were reviewed at a minimum follow up of 1 year.  All patients experienced significant pain relief, improved ankle ROM and ability to walk, and showed functional improvement as assessed by the Kofoed ankle score.  In two cases, deep infection led to prosthesis removal and conversion to ankle fusion.  Another patient showed painful progressive ossification of the joint capsule resulting in ankle fusion.4  The same patient cohort was again reviewed at a longer follow up and the results were published in another two studies.3,5  The authors reported a significant improvement of the Kofoed ankle score from 37.6 points preoperatively to 90.4 points postoperatively. Of 12 TARs performed 10-15 years before, 8 (67%) remained in situ (2 early deep infections, 2 aseptic loosenings).  In 20 implants inserted 5-10 years before, 3 were revised, leaving 17 (85%) in situ functioning well.  None of the implants with a follow-up of 1-5 years failed.  No results from independent authors have been published.

In summary, the limited studies performed by ESKA prosthesis designers reported favorable mid-term results with improved ankle ROM, pain relief, and ability to walk long distances postoperatively.3-5  However, the authors conceded that this surgery should be limited to only highly experienced foot and ankle surgeons due to the demanding lateral approach with fibular osteotomy.  As with the BOX TAR, published results have come from only the prosthesis designers.  Thus additional, independent analyses of ESKA efficacy are needed.

References

  1. Rudiger,J.: Ankle replacement by the cementless ESKA endoprosthesis. Tech Foot & Ankle, 4:125-136, 2005.
  2. Rudiger,J., Menzinger,F., and Grundei,H.: 14 Jahre Erfahrungen mit der zementfreien ESKA-Sprunggelenksendoprothese. Fuss Sprungg, 2:65-75, 2004.
  3. Rudigier,J.: Ankle replacement by the cementless ESKA endoprosthesis. Tech Foot & Ankle, 4:125-136, 2005.
  4. Rudigier,J., Grundei,H., and Menzinger,F.: Prosthetic replacement of the ankle in posttraumatic arthrosis: 10-year experience with the cementless ESKA ankle prosthesis. Eur J Trauma, 27:66-74, 2001.
  5. Rudigier,J., Menzinger,F., and Grundei,H.: 14 Jahre Erfahrungen mit der zementfreien ESKA-Sprunggelenksendoprothese. Fuss Sprungg, 2:65-75, 2004.

Peer Review

OrthopaedicsOne Peer Review Workflow is an innovative platform that allows the process of peer review to occur right within an OrthopaedicsOne article in an open, transparent and flexible manner. Learn more

Instructions for Authors

Read our Instructions for Authors to learn about contributing or editing articles on OrthopaedicsOne.

Content Partner

American Orthopaedic Foot and Ankle Society
This article is taken wholly from, or contains information that was originally published by the American Orthopaedic Foot and Ankle Society. Section editors and authors for OrthopaedicsOne may have edited its content or added new information. The use of information from the American Orthopaedic Foot and Ankle Society should not be construed as support for or endorsement by that organization for any new information added by OrthopaedicsOne members, or for any editing of the original content. Learn about the AOFAS.

Academic Resources

Resources on ESKA Ankle Prosthesis from Pubget.

Error rendering macro 'rss' : The RSS macro is retrieving an HTML page.
Orthopaedic Web Links

Internet resources validated by OrthopaedicWebLinks.com

Related Content

Resources on ESKA Ankle Prosthesis and related topics in OrthopaedicsOne spaces.

Page: Total ankle replacement (TAR) (OrthopaedicsOne Articles)
Page: Takedown of Painful Ankle Fusion and Total Ankle Replacement (OrthopaedicsOne Articles)
Page: Simultaneous Bilateral Total Ankle Replacement (OrthopaedicsOne Articles)
Page: Salto Total Ankle Prosthesis (OrthopaedicsOne Articles)
Page: Mobility Ankle System (OrthopaedicsOne Articles)
Page: TNK Total Ankle Replacement (OrthopaedicsOne Articles)
Page: German Ankle System (OrthopaedicsOne Articles)
Page: TARIC Total Ankle Replacement (OrthopaedicsOne Articles)
Page: BOX Total Ankle Replacement (OrthopaedicsOne Articles)
Page: Alphanorm Total Ankle Replacement (OrthopaedicsOne Articles)
Showing first 10 of 211 results