Comparison of Clinical Outcomes Between Ceramic-Based Total Ankle Arthroplasty with Ceramic Total Talar Prosthesis and Ceramic-Based Total Ankle Arthroplasty

2021 ◽  
pp. 107110072110513
Author(s):  
Tetsuya Yamamoto ◽  
Kanto Nagai ◽  
Noriyuki Kanzaki ◽  
Kiminari Kataoka ◽  
Koji Nukuto ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Revision Rate ◽  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Small Series ◽  
Significant Difference ◽  
End Stage

Background: Total ankle arthroplasty (TAA) has become one of the standard surgical treatments for patients with end-stage ankle osteoarthritis (OA). In recent years, TAA with total talar prosthesis (combined TAA) has been used for ankle OA patients with talar osteonecrosis, with severe talar collapse, or with subtalar joint OA. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA, compared with conventional TAA. Methods: Forty-six ankles (44 patients, 32 women/12 men) that underwent conventional TAA with mean follow-up of 42 months, and 26 ankles (25 patients, 18 women/7 men) that underwent combined TAA with mean follow-up of 46 months were included. Clinical outcomes, which included ankle range of motion (ROM), the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Self-Administered Foot Evaluation Questionnaire (SAFE-Q), and complications were compared between the groups. Results: The preoperative ROM was significantly worse in combined TAA for both dorsiflexion and plantarflexion; however, in the final ROM, there was no significant difference between the groups. There was no significant difference in JSSF scale and SAFE-Q between the groups. Revision rate was 10.9% in conventional TAA and 0% in combined TAA. Conclusion: In this small series, at an average of 3.5 years, we found no significant difference in clinical results between conventional TAA and combined TAA; however, the revision rate was higher in conventional TAA. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Mobile Anatomical Total Ankle Arthroplasty—Improvement of Talus Recentralization

2021 ◽  
Vol 10 (3) ◽  
pp. 554
Author(s):  
Faisal Alsayel ◽  
Mustafa Alttahir ◽  
Massimiliano Mosca ◽  
Alexej Barg ◽  
Mario Herrera-Pérez ◽  
...  
Keyword(s):  
Tibial Component ◽  
Mobile Bearing ◽  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Premature Failure ◽  
Ankle Arthroplasty ◽  
Significant Difference ◽  
The Mean ◽  
End Stage

Introduction: Total ankle arthroplasty (TAA) is becoming a more frequent treatment option for end-stage ankle osteoarthritis (OA) as outcomes measures are improving. However, there is concern that malalignment of TAA can result in premature failure of the implant. One of the malalignment issues is the talar sagittal malposition. However, a consensus on the significance of the sagittal translation of the talus in TAA is yet to be established. The aim of this study was, therefore, to clarify whether talus OA subluxation is normalized after the implantation of a mobile TAA. Methods: Forty-nine consecutive patients with symptomatic end-stage ankle OA underwent 50 cementless three-component mobile-bearing VANTAGE TAA with 21 right ankles (42%) and 29 left ankles (58%). Clinical and radiographic outcomes were assessed: Clinical variables: American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score (0–100), visual analogue scale (VAS, 0–10), and ankle range of motion (ROM). Radiological variables: medial distal tibial articular angle (mDTAA), anterior distal tibial articular angle (aDTAA) and lateral talar station (LTS). Results: The clinical results showed the mean improvement in AOFAS hindfoot score from 42.12 ± SE 2.42 (Range: 9–72) preoperatively, to 96.02 ± SE 0.82 (Range: 78–100) at a mean follow-up of 12 months, with a highly statistically significant difference (p < 0.00001). Pain score (VAS) was 6.70 ± SE 0.28 (Range 0–10) preoperatively, and 0.26 ± SE 0.12 (Range: 0–3) at 12-month follow-up, with a highly statistically significant difference (p < 0.00001). ROM measurements preoperatively showed a mean of 22.55° ± SE 1.51° (Range: 0–50°), which showed a statistically significant improvement (p < 0.0001) to 45.43° ± SE 1.56° (Range: 25–60°) 12 months postoperatively. The radiological analyses revealed the following results: On the coronal view, the mDTAA preoperatively was 88.61 ± SE 0.70 (Range: 78.15–101.10), which improved to 89.46 ± SE 0.40 (Range: 81.95–95.80) at 12 months (not statistically significant—p = 0.94). On the sagittal view, the preoperative values of the aDTAA showed 82.66 ± SE 0.84 (Range: 70.35–107.47), which improved to 88.98 ± SE 0.47 (Range: 82.83–96.32) at 12 months postoperatively, with a highly statistically significant difference between preoperative and 12-months values (p < 0.00001). The mean LTS values for all patients were 3.95 mm ± SE 0.78 (Range: −11.52 to 13.89) preoperatively and 1.14 mm ± SE 0.63 (Range: −10.76 to 11.75) at 12 months, with a statistically significant difference between preoperative and 12-month follow-up (p = 0.01). The review of the radiological TAA osteointegration at 12 months showed no cases of loosening of the implanted TAAs. Two cases (4%) showed a radiolucency and one case (2%) a cyst on the tibial component; no cases had a change on the talar component. No TAA complication/revision surgeries were documented. Conclusion: In the present study, the lateral talar station of anteriorly subluxated ankles showed a significant improvement, i.e., physiological centralization of the talus, in the postoperative period when a mobile-bearing TAA was performed. The anterior/posterior congruency between the talar component and the mobile polyethylene insert of the mobile-bearing VANTAGE TAA allows the sagittal translation of the talus relative to the flat tibial component, reducing the prosthesis strain and failure.

Radiographic and Clinical Outcomes of the Salto Talaris Total Ankle Arthroplasty

2020 ◽  
Vol 41 (12) ◽  
pp. 1519-1528
Author(s):  
Jonathan Day ◽  
Jaeyoung Kim ◽  
Martin J. O’Malley ◽  
Constantine A. Demetracopoulos ◽  
Jonathan Garfinkel ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Total Ankle Arthroplasty ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
The Mean ◽  
Component Revision

Background: The Salto Talaris is a fixed-bearing implant first approved in the US in 2006. While early surgical outcomes have been promising, mid- to long-term survivorship data are limited. The aim of this study was to present the survivorship and causes of failure of the Salto Talaris implant, with functional and radiographic outcomes. Methods: Eighty-seven prospectively followed patients who underwent total ankle arthroplasty with the Salto Talaris between 2007 and 2015 at our institution were retrospectively identified. Of these, 82 patients (85 ankles) had a minimum follow-up of 5 (mean, 7.1; range, 5-12) years. The mean age was 63.5 (range, 42-82) years and the mean body mass index was 28.1 (range, 17.9-41.2) kg/m2. Survivorship was determined by incidence of revision, defined as removal/exchange of a metal component. Preoperative, immediate, and minimum 5-year postoperative AP and lateral weightbearing radiographs were reviewed; tibiotalar alignment (TTA) and the medial distal tibial angle (MDTA) were measured to assess coronal talar and tibial alignment, respectively. The sagittal tibial angle (STA) was measured; the talar inclination angle (TIA) was measured to evaluate for radiographic subsidence of the implant, defined as a change in TIA of 5 degrees or more from the immediately to the latest postoperative lateral radiograph. The locations of periprosthetic cysts were documented. Preoperative and minimum 5-year postoperative Foot and Ankle Outcome Score (FAOS) subscales were compared. Results: Survivorship was 97.6% with 2 revisions. One patient underwent tibial and talar component revision for varus malalignment of the ankle; another underwent talar component revision for aseptic loosening and subsidence. The rate of other reoperations was 21.2% ( n = 18), with the main reoperation being exostectomy with debridement for ankle impingement ( n = 12). At final follow-up, the average TTA improved 4.4 (± 3.8) degrees, the average MDTA improved 3.4 (± 2.6) degrees, and the average STA improved 5.3 (± 4.5) degrees. Periprosthetic cysts were observed in 18 patients, and there was no radiographic subsidence. All FAOS subscales demonstrated significant improvement at final follow-up. Conclusions: We found the Salto Talaris implant to be durable, consistent with previous studies of shorter follow-up lengths. We observed significant improvement in radiographic alignment as well as patient-reported clinical outcomes at a minimum 5-year follow-up. Level of Evidence: Level IV, retrospective case series.

Comparison of Intermediate-term Outcomes of Total Ankle Arthroplasty in Primary and Ligamentous Post-traumatic Osteoarthritis

2019 ◽  
Vol 40 (11) ◽  
pp. 1273-1281 ◽  
Author(s):  
Gun-Woo Lee ◽  
Asep Santoso ◽  
Keun-Bae Lee
Keyword(s):  
Short Form ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Radiographic Outcomes ◽  
Primary Osteoarthritis ◽  
Post Traumatic ◽  
American Orthopaedic ◽  
End Stage

Background: Ankle ligamentous injuries without fracture can result in end-stage ligamentous post-traumatic osteoarthritis, which may cause ligamentous imbalance after total ankle arthroplasty (TAA). However, outcomes of TAA in these patients are not well known. The purpose of this study was to evaluate intermediate-term clinical and radiographic outcomes of TAA in patients with ligamentous post-traumatic osteoarthritis and compare them with results of TAA for patients with primary osteoarthritis. Methods: We enrolled 114 patients (119 ankles) with consecutive primary TAA using HINTEGRA prosthesis at a mean follow-up duration of 6.0 years (range, 3-13). We divided all patients into 2 groups according to the etiology of osteoarthritis: (1) primary osteoarthritis group (69 ankles) and (2) ligamentous post-traumatic osteoarthritis group (50 ankles). Results: There was no significant intergroup difference in mean Ankle Osteoarthritis Scale (AOS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Short Form-36 Physical Component Summary, visual analog scale pain score, ankle range of motion, or complications at the final follow-up. However, the final tibiotalar angle was less corrected to 4.2 degrees in the ligamentous post-traumatic osteoarthritis group compared to 2.7 degrees in the primary osteoarthritis group ( P = .001). More concomitant procedures were required at the index surgery for the ligamentous post-traumatic osteoarthritis group ( P = .001). The estimated 5-year survivorship was 93.4% (primary osteoarthritis group: 91.3%; ligamentous post-traumatic osteoarthritis group: 95.8%). Conclusions: Clinical outcomes, complication rate, and 5-year survivorship of TAA in ankles with primary and ligamentous post-traumatic osteoarthritis were comparable with intermediate-term follow-up. Our results suggest that TAA would be a reliable treatment in ankles with ligamentous post-traumatic osteoarthritis when neutrally aligned stable ankles are achieved postoperatively. Level of Evidence: Level III, retrospective cohort study.

Clinical Outcomes of Total Ankle Arthroplasty With Total Talar Prosthesis

2019 ◽  
Vol 40 (8) ◽  
pp. 948-954
Author(s):  
Noriyuki Kanzaki ◽  
Nobuaki Chinzei ◽  
Tetsuya Yamamoto ◽  
Takahiro Yamashita ◽  
Kazuyuki Ibaraki ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Total Ankle Arthroplasty ◽  
Medial Malleolus ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
The Mean ◽  
End Stage ◽  
Medial Malleolus Fracture

Background: Total ankle arthroplasty (TAA) has been developed to treat patients with end-stage ankle osteoarthritis (OA). However, there is often difficulty in treating complicated pathologies such as ankle OA with subtalar joint OA and severe talar collapse. Therefore, this study aimed to explore the short-term results and complications of TAA with total talar prosthesis, known as combined TAA, as the new techniques to treat such complicated pathology. Methods: We examined postoperative results including ankle range of motion, Japanese Society for Surgery of the Foot (JSSF) scale, and complications. There were 22 patients (15 women), with mean follow-up of 34.9 (range, 24–53 months), and the mean age was 72 (range, 62–80) years. The main indications for combined TAA included osteoarthritis (18 patients), rheumatoid arthritis (3 patients), and talar osteonecrosis with osteoarthritis (one patient). Results: The mean range of motion improved from 4.0 to 14.4 degrees in dorsiflexion and from 23.8 to 32.0 degrees in plantarflexion. The JSSF scale improved from 50.5 to 91.5 points. Prolonged wound healing occurred in 3 patients, and medial malleolus fracture occurred in 4 patients. Conclusion: Combined TAA was a reliable procedure for the treatment of not only ankle OA following avascular necrosis of talus but also of degeneration of both ankle and subtalar joints. Level of Evidence: Level IV, case series.

scholarly journals Total ankle arthroplasty incorporating a total talar prosthesis

2019 ◽  
Vol 101-B (4) ◽  
pp. 443-446 ◽  
Author(s):  
H. Kurokawa ◽  
A. Taniguchi ◽  
S. Morita ◽  
Y. Takakura ◽  
Y. Tanaka
Keyword(s):  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Custom Made ◽  
The Mean ◽  
Ct Data ◽  
End Stage ◽  
And Function

AimsTotal ankle arthroplasty (TAA) has become the most reliable surgical solution for patients with end-stage arthritis of the ankle. Aseptic loosening of the talar component is the most common complication. A custom-made artificial talus can be used as the talar component in a combined TAA for patients with poor bone stock of the talus. The purpose of this study was to investigate the functional and clinical outcomes of combined TAA.Patients and MethodsTen patients (two men, eight women; ten ankles) treated using a combined TAA between 2009 and 2013 were matched for age, gender, and length of follow-up with 12 patients (one man, 11 women; 12 ankles) who underwent a standard TAA. All had end-stage arthritis of the ankle. The combined TAA features a tibial component of the TNK ankle (Kyocera, Kyoto, Japan) and an alumina ceramic artificial talus (Kyocera), designed using individualized CT data. The mean age at the time of surgery in the combined TAA and standard TAA groups was 71 years (61 to 82) and 75 years (62 to 82), respectively. The mean follow-up was 58 months (43 to 81) and 64 months (48 to 88), respectively. The outcome was assessed using the Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale, the Ankle Osteoarthritis Scale (AOS), and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q).ResultsThe mean preoperative JSSF score of the combined TAA and standard TAA groups was 44 (sd 11) and 49 (sd 10), respectively. The mean postoperative JSSF scores were 89 (sd 6.1) and 72 (sd 15), respectively. The mean postoperative JSSF score of the combined TAA group was significantly higher (p = 0.0034). The mean preoperative AOS scores for pain and function in the combined TAA and standard TAA groups were 5.8 (sd 3.3) and 5.5 (sd 3.1), and 8.6 (sd 1.3), and 7.1 (sd 2.9), respectively. The mean postoperative AOS scores of pain and function were 2.5 (sd 2.5) and 2.2 (sd 1.9), and 2.5 (sd 3.3) and 3.4 (sd 2.9), respectively. There were no significant differences between the two groups in terms of postoperative AOS scores. The mean postoperative SAFE-Q scores were: for pain, 76 (sd 23) and 70 (sd 23); for physical function, 66 (sd 25) and 55 (sd 27); for social function, 73 (sd 35) and 62 (sd 34); for shoe-related, 73 (sd 19) and 65 (sd 26); and for general health, 78 (sd 28) and 67 (sd 29), respectively. There were no significant differences between the two groups in terms of postoperative SAFE-Q scores.ConclusionCombined TAA resulted in better clinical results than standard TAA. Cite this article: Bone Joint J 2019;101-B:443–446.

Comparison of Clinical Outcomes After Total Ankle Arthroplasty Between End-Stage Osteoarthritis and Rheumatoid Arthritis

2021 ◽  
pp. 107110072097992
Author(s):  
Byung-Ki Cho ◽  
Min-Yong An ◽  
Byung-Hyun Ahn
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Outcomes ◽  
Immunosuppressive Treatment ◽  
Total Ankle Arthroplasty ◽  
Complication Rates ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Sports Activity ◽  
Ankle Arthroplasty ◽  
End Stage

Background: Total ankle arthroplasty (TAA) is known to be a reliable operative option for end-stage rheumatoid arthritis. However, higher risk of postoperative complications related to chronic inflammation and immunosuppressive treatment is still a concern. With the use of a newer prosthesis and modification of anti-rheumatic medications, we compared clinical outcomes after TAA between patients with osteoarthritis and rheumatoid arthritis. Methods: Forty-five patients with end-stage osteoarthritis (OA group) and 19 with rheumatoid arthritis (RA group) were followed for more than 3 years after 3 component mobile-bearing TAA (ZenithTM). Perioperative anti-rheumatic medications were modified using an established guideline used in total hip and knee arthroplasty. Clinical evaluations consisted of American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM). Results: In the preoperative and postoperative evaluation at final follow-up, there were no significant differences in AOFAS, FAOS, and FAAM scores between 2 groups. Despite statistical similarity in total scores, the OA group showed significantly better scores in FAOS sports and leisure (mean, 57.4 ± 10.1) and FAAM sports activity (mean, 62.5 ± 13.6) subscales than those in the RA group (mean, 52.2 ± 9.8, P = .004; and 56.4 ± 13.2, P < .001, respectively). There were no significant differences in perioperative complication and revision rates between 2 groups. Conclusions: Patients with end-stage ankle RA had clinical outcomes comparable to the patients with OA, except for the ability related to sports activities. In addition, there were no significant differences in early postoperative complication rates, including wound problem and infection. Level of Evidence: Level III, prognostic, prospective comparative study.

scholarly journals Increased Early Revision Rate With the INFINITY Total Ankle Prosthesis

2018 ◽  
Vol 40 (1) ◽  
pp. 9-17 ◽  
Author(s):  
Elizabeth A. Cody ◽  
Michel A. Taylor ◽  
James A. Nunley ◽  
Selene G. Parekh ◽  
James K. DeOrio
Keyword(s):  
Tibial Component ◽  
Revision Rate ◽  
Case Series ◽  
Total Ankle Arthroplasty ◽  
Secondary Outcome ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Early Revision ◽  
Component Loosening

Background: A number of new 2-component total ankle arthroplasty systems that emphasize minimal bone resection have been introduced for which few clinical outcomes reports are available. Our aim was to identify the rate of early revision among patients receiving the 2-component INFINITY prosthesis. Methods: Patients from 2 prospectively collected databases at the authors’ institution were screened for inclusion in the present study. All patients who underwent a primary total ankle arthroplasty (TAA) with the INFINITY prosthesis and who were at least 1 year postoperative were included. A total of 159 ankles with a mean 20 months of follow up (range, 12-37) met these criteria. All surgeries were performed by 1 of 2 orthopedic foot and ankle surgeons with extensive experience in TAA. The primary outcome was the need for revision surgery, defined as removal of 1 or both metal components. Peri-implant lucency at most recent follow-up was a secondary outcome. Weightbearing radiographs at most recent follow-up were graded for lucency independently by 2 reviewers. Results: Sixteen ankles (10%) underwent revision at a mean 13 months postoperatively. The most common reasons for revision were symptomatic tibial component loosening and deep infection (6 patients each, 3.8%). Of the 108 ankles with retained components and at least 1 year of radiographic follow-up, 8 (7.4%) had global lucency around the tibial component suggestive of loosening at most recent follow-up. Conclusions: Our initial review of patients undergoing TAA with this new 2-component prosthesis demonstrates an elevated early revision rate due to tibial component loosening compared to other implant systems. Level of Evidence: Level IV, case series.

Comparison of Total Ankle Arthroplasty and Ankle Arthrodesis in End-Stage Hemophilic Arthropathy

2020 ◽  
Vol 41 (8) ◽  
pp. 937-944
Author(s):  
Jungtae Ahn ◽  
Myung Chul Yoo ◽  
Jeunghwan Seo ◽  
Moonsu Park ◽  
Bi O Jeong
Keyword(s):  
Ankle Arthrodesis ◽  
Outcome Evaluation ◽  
Total Ankle Arthroplasty ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
The Mean ◽  
Retrospective Comparative Study ◽  
End Stage ◽  
Clinical And Radiological Results

Background: Total ankle arthroplasty (TAA) can result in excellent outcomes in patients with end-stage arthritis, but most patients with end-stage hemophilic ankle arthropathy (ESHAA) still undergo ankle arthrodesis (AA). The purpose of this study was to analyze clinical and radiological results of TAA and AA for ESHAA. Methods: A total of 29 cases (16 TAAs and 13 AAs) of painful ESHAA were included. For clinical outcome evaluation, visual analog scale (VAS) for pain, Foot Function Index (FFI), and range of motion (ROM) were analyzed. Postoperative clinical and radiological complications were also analyzed. The mean duration of follow-up was 6.8 ± 3.0 years. The mean age was 44.1 ± 9.9 years. Results: The VAS for pain was significantly improved from 5.5 ± 2.3 to 0.9 ± 1.2 ( P < .001). The FFI scale was significantly improved from 61.6% ± 15.5% to 16.6% ± 15.4% ( P < .001). In FFI disability and activity subscales, the TAA group exhibited meaningful outcomes relative to those of the AA group ( P = .012 and .036, respectively). The total ROM in the TAA group changed from 30.8 ± 12.6 degrees to 37.3 ± 12.8 degrees at final follow-up ( P = .090). Three cases of osteolysis and 1 case of heterotopic ossification were noted in the TAA group. No cases of nonunion were noted in the AA group. Progressive arthrosis of adjacent joints after AA was observed in 1 case. Conclusion: Both TAA and AA in ESHAA exhibited significant improvement in pain based on VAS and FFI scales. Compared to AA, TAA resulted in superior outcomes in FFI disability and activity subscales, suggesting that TAA may be considered as a surgical option alongside AA for ESHAA. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Patient-Reported Outcomes Before and After Primary and Revision Total Ankle Arthroplasty

2018 ◽  
Vol 40 (1) ◽  
pp. 34-41 ◽  
Author(s):  
James R. Lachman ◽  
Jania A. Ramos ◽  
Samuel B. Adams ◽  
James A. Nunley ◽  
Mark E. Easley ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
High Volume ◽  
Clinical Results ◽  
Patient Reported Outcome ◽  
Total Ankle Arthroplasty ◽  
Study Patient ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
Before And After

Background: Studies examining the clinical outcomes of revision total ankle arthroplasty (TAA) are sparse. Revision TAA surgery has become more common with availability of revision implants and refinement of bone-conserving primary implants. In this study, patient-reported results and clinical outcomes were analyzed for a cohort of patients who underwent both primary and revision TAA at a single high-volume institution. Methods: We retrospectively reviewed prospectively collected data on 29 patients with failed primary total ankle arthroplasty. Cases of isolated polyethylene exchange, infection, or extra-articular realignment procedures were excluded. Patient-reported outcome (PRO) measures and clinical results were reviewed in this longitudinal study. Results: Fifteen patients (51.7%) underwent revision of just the talar and polyethylene components while 13 patients (44.8%) underwent revision of all components. The most common cause was talar subsidence (51.7%). The average time to revision was 3.9 years with a follow-up of 3.2 years after revision, and 3 (10.3%) revision arthroplasties required further surgery; 2 required conversion to arthrodesis and 1 required second revision TAA. Improvements in PROs were better after primary than revision TAA. Conclusions: Clinical and patient-reported results of revision ankle arthroplasty after metal component failure improved significantly but never reached the improvements seen after primary ankle arthroplasty. In our series, 10.3% of revision TAAs required a second revision TAA or arthrodesis surgery. Levels of Evidence: Therapeutic Level III, comparative series.

Results of Trabecular-Metal Total Ankle Arthroplasties With Transfibular Approach

2019 ◽  
Vol 41 (4) ◽  
pp. 411-418 ◽  
Author(s):  
Hannu Tiusanen ◽  
Sami Kormi ◽  
Ia Kohonen ◽  
Mikhail Saltychev
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Total Ankle Arthroplasty ◽  
Trabecular Metal ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Functional Scores ◽  
Component Loosening ◽  
And Function

Background: Total ankle arthroplasty is an alternative for arthrodesis. The objective of this study was to investigate the safety of trabecular-metal ankle prosthetic system with transfibular approach and external frame and its association with changes in clinical and functional scores. Methods: Between May 2013 and June 2017, a total of 104 consecutive patients underwent primary total ankle arthroplasty with a trabecular metal implant. The prospective clinical and radiographic data were collected. The mean follow-up time was 43.6 (14.6) months. Results: Of 104 patients, 88 (89%) reported improved functioning and 65 (66%) were very satisfied with the surgery. Of the patients, 51 (50%) did not report any pain at the end of follow-up at all. The average Kofoed score was 37.6 (SD 17.4) points at baseline and 74.8 (SD 20.6) points at the end of follow-up. There were 37 additional procedures, and the complication rate was nearly 20%. Conclusion: Trabecular-metal total ankle prosthesis showed promising clinical results concerning pain and function. At 5-year follow-up, osteolysis and component loosening were rare. Level of Evidence: Level IV, case series.

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