scholarly journals A Retrospective Analysis of Results and Outcomes after Cadence Total Ankle Arthroplasty Implanted through the End of 2017

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0021
Author(s):  
Brianna R. Fram ◽  
Ryan G. Rogero ◽  
Daniel Corr ◽  
David I. Pedowitz ◽  
Justin Tsai
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
Failure Modes ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
Foot And Ankle ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Component Loosening

Category: Ankle; Ankle Arthritis Introduction/Purpose: Total ankle arthroplasty (TAA) is an increasingly popular operative treatment of ankle arthritis, due to its ability to decrease adjacent joint degeneration and preserve gait mechanics compared to ankle arthrodesis. However, ankle arthroplasty components have a shorter mean longevity then their hip, knee, or shoulder counterparts. The Cadence TAA entered clinical use in 2016 and was designed to address common failure modes of prior systems. We report here on radiographic and clinical outcomes and early complications of the Cadence TAA system at a minimum of 2 years follow-up. Methods: Patients who underwent primary Cadence TAA from 2016 through 2017 by one fellowship-trained foot and ankle surgeon were eligible. Exclusion criteria included prior ipsilateral ankle arthrodesis or arthroplasty and lack of followup. Chart review was performed for eligible patients to identify complications and reoperations. Patients were contacted to obtain Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sport subscores, SF-12 Mental (MCS) and Physical Health (PCS) subscores, and Visual Analog Scale (VAS) pain levels (rated 0-100). Scores were analyzed with 2-sided repeated measures T- tests, with P<0.05 as significant. A second, blinded, fellowship-trained foot and ankle surgeon evaluated followup 5-view radiographs of each ankle to measure range of motion (ROM), alignment, peri-implant osteolysis, and component loosening or subsidence. Subsidence or loosening were defined, respectively, as >2mm or >2⁰ change in position for the tibial component and >5mm or >5⁰ change for the talar component. Results: Sixty patients were included with mean age 64 and mean BMI 32.0. Thirty patients (50%) had concurrent other procedure(s). FAAM-ADL, FAAM-Sports, SF-12 PCS, and VAS pain scores all improved significantly at mean 2.24 years post-op (Table 1). Ten patients (6.7%) had operative complications requiring 15 surgeries (mean 265 days to first reoperation). Three patients (5%) required removal of one or both components, for 2-year implant survival of 95.0%. Two revisions were for infection and one for osteolysis. This produced a mechanical failure rate of 1/60 (1.7%). Radiographic analysis revealed average coronal alignment improved from 7.4⁰ from neutral preoperatively to 2.2⁰ postoperatively. Average ROM was 36.5⁰ total arc of motion. One of 38 (2.6%) had signs of peri-implant osteolysis, with no cases demonstrating loosening or subsidence. Conclusion: Two-year follow-up of the Cadence TAA system demonstrates mechanically stable implants resulting in improved patient function and preserved ankle range of motion. Outcomes compare favorably to those of other TAA systems at 2-year follow-up. Further radiographic and clinical follow-up are needed to evaluate implant longevity and long-term patient functional outcomes. [Table: see text]

scholarly journals Role of Total Ankle Arthroplasty in Stiff Ankles – Long Term Follow-Up

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0001
Author(s):  
James W. Brodsky ◽  
Justin M. Kane ◽  
Andrew W. Pao ◽  
David D. Vier ◽  
Scott Coleman ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Step Length ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Post Surgery ◽  
Long Term Follow Up ◽  
Gait Function

Category: Ankle, Ankle Arthritis Introduction/Purpose: Operative treatment of end-stage ankle arthritis involves either ankle arthrodesis (AA) or total ankle arthroplasty (TAA). The theoretical benefit of TAA is the ability to preserve range of motion (ROM) at the tibiotalar joint. Previous studies have questioned whether it is justified to perform TAA over AA in stiff, arthritic ankles. However, a recent study showed that patients who underwent TAA with stiff ankles preoperatively experienced significant clinical improvement in range of motion and gait function compared to more flexible groups at 1-year follow-up. We retrospectively assessed these same gait and functional parameters to see if these improvements held up in long-term follow-up. Methods: A retrospective study of long-term, prospectively collected functional gait data in 33 TAA patients at a mean of 7.6 years postoperatively (range 4.8-13.3) used a multivariate regression model to determine the effect of ankle stiffness on the long- term, objective outcomes of TAA. Data was analyzed by quartiles (Q1, Q2+Q3, Q4) of preoperative sagittal ROM using one-way analysis of variance (ANOVA) to compare both preop and postop gait parameters. The two middle quartiles were combined to conform to distribution of the data. The multivariate analysis determined the independent effect of age, gender, BMI, years post- surgery, and preop ROM on every preop and postop parameter of gait. Results: Statistically significant differences were found in all three gait parameter categories, including temporal-spatial (step length and walking speed), kinematic (total sagittal ROM and maximum plantarflexion), and kinetic (peak ankle power). The stiffest ankles preoperatively (Q1) had the greatest absolute increase in total sagittal ROM postoperatively, +5.3o, compared to -1.3o (p<0.0174) in Q4 (most flexible). However, Q1 had the lowest absolute total postoperative sagittal ROM of 13.1 o, compared to 19.7 o (p<0.0108) in Q4. Q1 also had the lowest preoperative step length, walking speed, maximal plantarflexion, and peak ankle power when compared to the other subgroups. There was no difference in any of these same parameters postoperatively. BMI and years post-surgery had no effect on outcomes, while age and gender had a minimal effect. Conclusion: Preoperative range of motion was once again predictive of overall postoperative gait function in long-term follow-up at an average of 7.2 years. A greater degree of preoperative sagittal range of motion was predictive of greater postoperative sagittal range of motion in long-term follow-up. Patients with the stiffest ankles preoperatively once again had a statistically and clinically greater improvement in function as measured by multiple parameters of gait. This shows that the clinically meaningful improvement in gait function after total ankle arthroplasty holds up in long-term follow-up, even in the setting of limited preoperative sagittal range of motion.

scholarly journals Conversion of Ankle Fusions to Ankle Replacements

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0051
Author(s):  
Stephen White ◽  
Bruce Cohen ◽  
Carroll Jones ◽  
Michael Le ◽  
W. Hodges Davis
Keyword(s):  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Patient Reported ◽  
Fusion Site ◽  
Foot Function ◽  
Patient Related Outcome ◽  
Improved Function

Category: Ankle Arthritis Introduction/Purpose: Ankle arthrodesis remains a prominent treatment choice for ankle arthritis in a majority of patients. Long term studies have shown a compensatory development of ipsilateral adjacent joint arthritis after ankle arthrodesis, and some patients who receive an ankle arthrodesis develop pain in surrounding joints, or even at the fusion site. As total ankle arthroplasty (TAA) design, instrumentation, and techniques have improved, the use of total ankle arthroplasty has become more widespread. Very few studies have been published on conversion of ankle arthrodesis to ankle arthroplasty, but they have shown improved function and patient-related outcome scores. The purpose of this study was to assess the radiographic, clinical, and patient-reported outcomes of patients undergoing ankle arthroplasty after conversion from a CT-confirmed ankle arthrodesis. Methods: This was a retrospective cohort study of patients with previous CT-confirmed ankle arthrodesis who underwent conversion to total ankle arthroplasty. Minimum follow up was 1 year. Nonunions of ankle arthrodesis were excluded. AOFAS ankle-hindfoot score, foot function index (FFI), pain, revision surgeries, complications, and patient demographics were assessed. Radiographs prior to TAA, and at latest follow-up were also reviewed. Results: 10 patients were included in the study with an average age of 54.5 years. No implants had to be revised. 1/10 (10%) patients had to undergo secondary surgery for heterotopic ossification removal. The same patient had to undergo another subsequent surgery for posterior ankle decompression. 2/10 (20%) patients had a mild talar subsidence of the TAA at latest follow-up, with no patients having tibial subsidence. Talar osteolysis was noticed in 2 patients (20%) at latest follow-up, with no patients having tibial osteolysis. Only one patient (10%) was noted to have a mild valgus alignment of TAA with no varus malalignments. All radiographic changes noted were clinically asymptomatic. The average AOFAS total score was 58 (range 23,89). The mean FFI total score was 41.9 (range 0,90). Conclusion: Conversion of ankle fusion to TAA is a challenging operation but can be a viable option for patients with ongoing pain after an ankle arthrodesis. We noted low revision rates and few complications at 1 year.

scholarly journals Minimum 20 Year Follow-Up of Semi-Constrained Total Ankle Arthroplasty

2017 ◽  
Vol 2 (2) ◽  
pp. 2473011416S0000
Author(s):  
Taylor Den Hartog ◽  
Samuel Carlson ◽  
Greg Alvine ◽  
Frank Alvine ◽  
Bryan Den Hartog ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
The United States ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
Cobalt Chromium ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Entire Cohort ◽  
Ankle Replacement

Category: Ankle Arthritis Introduction/Purpose: With the introduction of newer generations of total ankle arthroplasty (TAA) constructs, the incidence of TAA in the United States has been increasing. While TAA has emerged as an alternative to ankle arthrodesis for the management of end-stage ankle arthritis, long-term data evaluating clinical outcomes and the survivorship of ankle prostheses is lacking. The purpose of this study was to report the clinical outcomes and radiographic survivorship of a second-generation, semi-constrained titanium and cobalt-chromium total ankle prosthesis at minimum twenty-year follow-up in order to provide a benchmark comparison for future generations of TAA design. Methods: 132 total ankle replacements in 126 patients were performed by a single surgeon between July 1984 and October 1994. Follow-up evaluation consisted of determining revision status, completion of the validated ankle osteoarthritis scale, a short questionnaire, and a review of the available radiographs. All radiographs were evaluated for evidence of progressive radiolucent lines, osteolysis and component subsidence. Results: At minimum twenty-year follow-up, 37 patients were alive, 89 were deceased, and 5 were lost to follow-up. For living patients, average clinical follow up was 25.3 years. Average radiographic follow-up was 21.4 years. Over the minimum 20 year follow-up, 29 ankles were revised (23%). For living patients, 13 ankles were revised (35%). Conclusion: Twenty-three percent of all patients and 35% of living patients required a revision over the minimum 20 year follow up interval. 65% of living patients have retained their prosthesis and 75% of the entire cohort are still functioning with their original ankle replacement or died with the original ankle replacement in place. This study should provide a benchmark for newer designs when they obtain this length of follow-up.

scholarly journals Total Ankle Arthroplasty vs Ankle Arthrodesis

2018 ◽  
Vol 3 (2) ◽  
pp. 2473011418S0001
Author(s):  
Thomas Clanton ◽  
Lauren Matheny ◽  
Angela Chang
Keyword(s):  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
Proportional Hazard ◽  
Foot And Ankle ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Cox Proportional Hazard ◽  
Age At Surgery ◽  
Significant Difference ◽  
Surgical Failure

Category: Ankle, Ankle Arthritis Introduction/Purpose: Ankle arthritis is a debilitating disorder which significantly limits activities of daily living and can lead to reduced quality of life. Total ankle arthroplasty(TAA) and ankle arthrodesis are common treatments for ankle arthritis; however, patient indications may differ based on individual patient needs. Few studies compare proportional hazard modeling, survivorship and patient-centered outcomes following these two procedures, which may be useful in determining the appropriate procedure for end-stage ankle arthritis in different patient populations. The purpose of this study was to determine proportional hazards for the risk of failure in patients who underwent TAA vs. arthrodesis, as well as survivorship and outcomes. Methods: All patients >18 years, between January 2009 and November 2013, who underwent TAA or ankle arthrodesis by a single surgeon for treatment of ankle arthritis were included. Patients completed a subjective questionnaire at minimum 2-years following index surgery. Outcomes measures included Foot and Ankle Ability Measure(FAAM), Foot and Ankle Disability Index(FADI), Lysholm, WOMAC, SF-12 physical component summary(PCS) and mental component summary(MCS), Tegner activity scale and patient satisfaction with outcome. Detailed surgical data/intraoperative findings were documented at time of surgery. All data were collected prospectively. Cox proportional hazard modeling and survivorship analysis were performed to assess differences between the two cohorts. Survivorship utilizing Kaplan-Meier method, using a log-rank test, was used to compare median survivorship. Cox-proportional hazard model was conducted to compare hazard rates of surgical failure for patients in each cohort, while adjusting for age at surgery, body mass index(BMI) and sex. All outcome measures were compared between cohorts. Results: There were 97 patients available for analysis. Eight patients failed surgery(9.2%). Demographic data were documented (Table 1). There was no significant difference in failures (TAA=2 failures (6.5%) vs. arthrodesis=6 failures (11.8%)(p=0.709). There was no significant difference in survivorship of surgery between the arthrodesis cohort and the TAA cohort(p=0.785)(Table 1, Figure 1). There was a decrease in survivorship at 4 years in TAA cohort compared to arthrodesis cohort, which was not significant. The hazard ratio was 0.804 [95%CI: 0.111–5.842], indicating that cohort did not have a significant effect on the hazard of surgical failure(p=0.829). Sex, age and BMI did not have a significant effect on the hazard of surgical failure(p>0.05). There was no significant difference in any outcome measures between cohorts(Table 1). Conclusion: There was no significant difference in survivorship or in the hazard of surgical failure based on cohort (TAA and arthrodesis) while accounting for sex, age at surgery and BMI. There was no significant difference in the hazard of surgical failure for factors including age at surgery, BMI or sex. There was no significant difference in survivorship or outcomes between cohorts. Total ankle arthroplasty seems to provide similar results as arthrodesis; however, there was a decrease in survivorship at 4 years in the TAA cohort. Although not significant, this may indicate that survivorship differs during the longer-term follow-up period.

scholarly journals Total Ankle Arthroplasty Results Using Fixed Bearing CT-Guided Implants in Post-Traumatic Versus Non-Traumatic Arthritis

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0009
Author(s):  
Assaf Albagli ◽  
Susan M. Ge ◽  
Patrick Park ◽  
Dan Cohen ◽  
E. Ruth Chaytor ◽  
...  
Keyword(s):  
Total Ankle Arthroplasty ◽  
Patient Specific ◽  
Foot And Ankle ◽  
Fixed Bearing ◽  
Ankle Arthritis ◽  
Ankle Osteoarthritis ◽  
Ankle Arthroplasty ◽  
Traumatic Group ◽  
Post Traumatic

Category: Ankle; Ankle Arthritis; Trauma Introduction/Purpose: The majority of ankle osteoarthritis are post-traumatic in etiology. Previous studies have shown that patients with post-traumatic ankle osteoarthritis are less satisfied, experience significantly more pain during normal activities and have higher revision rates. However, these studies were performed with older generation implants. The objective of this study was to compare patients hat had undergone total ankle arthroplasty secondary to either post-traumatic or non-traumatic etiologies using patient specific, third generation fixed bearing implants and compare clinical as well as radiographic outcomes. Methods: A retrospective chart review was conducted on 41 patients who had undergone total ankle arthroplasty using a third- generation fixed bearing implant with CT-based patient specific cutting guides from July 21, 2015 to December 13, 2017 performed by 2 foot and ankle surgeons. Demographic and operative data was collected. Etiology was determined based on clinical notes, operative notes, and x-rays. Clinical outcomes were obtained using the Foot and Ankle Ability Measure questionnaire. Radiographic assessment of the coronal and sagittal alignments were carried out to assess implant migration or loosening. Results: We had 26 patients in the post-traumatic group and 15 in the non-traumatic group with a mean follow-up of 32.5 months and 30.4 months respectively. There was no significant difference between both groups in terms of FAAM ADL subscore with the post-traumatic group did slightly better with 7 patients scoring ‘nearly normal’ (26.9%) and 18 patients scoring ‘normal’ (69.2%). Whereas in the non-traumatic group 5 patients score ‘nearly normal’ (33.3%) and 9 patients score ‘normal’ (60%). In terms of the self-rated subjective functioning score, mean score of 79.2% and 73.4% respectively. On radiographs, there was no subsidence or significant implant movement for both groups at mean follow-up of 28.3 months for the post-traumatic group and 26.3 months for the non-traumatic group. Conclusion: Unlike in previous studies in older implants where clinical outcomes were worse in post-traumatic ankle arthritis, our study showed that those receiving total ankle arthroplasty due to post traumatic osteoarthritis do slightly better than those with non-traumatic osteoarthritis, with more patients reporting normal levels of activity. These results may help quantify improvements in newer generation patient specific implants as well as to gain insight into how different implant designs affect post- operative outcomes based on etiology of ankle osteoarthritis.

scholarly journals Outcomes and Gait Mechanics after Ankle Arthrodesis Take Down with Total Ankle Arthroplasty or Subtalar Fusion in Patients with Previous Tibiotalar Arthrodesis: A Comparative Study

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0010
Author(s):  
Lorena Bejarano Pineda ◽  
Robin Queen ◽  
Franklin R. Gergoudis ◽  
Manuel J Pellegrini ◽  
Mark E. Easley
Keyword(s):  
Range Of Motion ◽  
Patient Reported Outcomes ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthritis ◽  
Ankle Arthroplasty ◽  
Subtalar Fusion ◽  
Patient Reported ◽  
Gait Mechanics ◽  
Tibiotalar Arthrodesis

Category: Ankle, Ankle Arthritis, Basic Sciences/Biologics, Hindfoot Introduction/Purpose: Ankle arthrodesis has traditionally been the treatment of choice for ankle arthritis. However, loss of range of motion, chronic pain, risk of nonunion, and potential risk of adjacent arthritis are ongoing concerns after this procedure. Most of surgeons state that subtalar fusion is an alternative to treat a painful and dysfunctional ankle fusion, but successful ankle arthrodesis take down using Total Ankle Arthroplasty (TAA) has been reported in the literature. The paucity of literature comparing these two treatment methods hinders the ability to make an informed decision on the best therapy. The purpose of the study was to compare patient-reported outcomes; gait mechanics and complications in patients with ankle arthrodesis take down using TAA to those who underwent subtalar fusion in a previously fused ankle. Methods: This is a comparative study of patients who underwent tibiotalar arthrodesis take down with total ankle arthroplasty and subtalar arthrodesis in previously arthrodesed ankles. Patients who were willing to take the gait mechanics test were included. They were distributed in two groups according to the undergone procedure. Postoperative outcomes consisted of patient- reported functional measures, and complications rate. Patient-reported functional measures included the American Orthopaedic Foot & Ankle Society Score (AOFAS) hindfoot scale, Visual Analogue Scale (VAS) for pain, and the Short Form 36 Health Survey (SF-36). Three-dimensional joint mechanics and ground reaction forces were measured during level walking at least one-year post surgery. Gait mechanics included spatiotemporal parameters, and the peak plantar and dorsiflexion moment. Data were analyzed using analysis of variance (ANOVA) to determine significant differences between the two groups. (a = 0.05). Results: Ten patients were included in the ankle arthrodesis taken down (AATD) group, and seven patients were included in the subtalar fusion (STF) group. The average follow-up time in the AATD and SFT group was 70.4 and 46 months, respectively P=0.14. There were no statistically significant differences in the demographics of both groups. The peak plantar flexion was 4.6 degrees and 1.3 degrees in the AATD and STF group, respectively; P=0.04. The range of motion in the sagittal plane was 11.5 degrees and 7.8 degrees in patients with AATD and STF groups, respectively; P=0.13. The complication rate was higher in the AATD group (7 patients, 70% vs 1 patient, 14%; P=0.02). There were no statistically significant differences in the patient-reported outcomes between the two groups. Conclusion: Patients with ankle arthrodesis taken down using total ankle arthroplasty as compared with patients with tibiotalocalcaneal arthrodesis have better range of motion of the hindfoot and improved gait mechanics. The improved cadence and mobility decreased the imbalance in the midfoot and forefoot during the gait. Nevertheless, due to the complexity of the procedure the complication rate is considerably higher. Further research with a larger sample of both groups may demonstrate greater differences in patient-reported outcomes.

scholarly journals Multi-Segment Foot and Ankle Gait Kinematics Following Total Ankle Arthroplasty

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0048
Author(s):  
Dylan Wiese ◽  
Jessica M. Fritz ◽  
Karl Canseco ◽  
Carolyn M. Meinerz ◽  
Katherine Konop ◽  
...  
Keyword(s):  
Stance Phase ◽  
Swing Phase ◽  
Total Ankle Arthroplasty ◽  
Foot And Ankle ◽  
Ankle Arthritis ◽  
Control Data ◽  
Kinematic Data ◽  
Ankle Arthroplasty ◽  
Gait Kinematics

Category: Ankle Arthritis; Ankle. Introduction/Purpose: Ankle arthritis is a painful disease resulting in limited function, mobility, and quality of life.1 Total ankle arthroplasty (TAA) a widely accepted treatment to reduce pain while maintaining joint motion.2,3 There are two common types of implants: fixed bearing (FB) and mobile bearing (MB). Comparisons of these implants have shown similar patient and clinical outcomes;4 however, post-operative gait kinematics from a multi-segment foot and ankle model have not been compared. This study assessed multi-segmental foot and ankle gait kinematics between persons following TAA with MB and FB implants and compared them to control data of adult ambulators without lower extremity pathology. Methods: This was a prospective analysis of persons who had previously underwent TAA with a MB (n=6; average follow-up period of 2.5 years) implant. After consenting to the IRB-approved study, participants were fitted with reflective markers for the Milwaukee Foot Model (MFM).5 Participants walked barefoot along a 30-foot walkway at a comfortable, self-selected pace for a minimum of ten trials while twelve infrared motion capture cameras recorded data. Kinematic data from the MB group and historical data from a FB population who underwent the same protocol with the MFM (n=7; average follow-up period of 2 years) were compared to control data (n=37). Welch’s two-tailed t-tests were used to calculate statistical significance at an alpha level of 0.05. Deviation from control data was compared between both implant groups. Results: In the MB group, sagittal motion of the hindfoot, forefoot, and hallux were significantly different from control for the majority of stance. The only significant MB group swing phase differences were early swing sagittal kinematics in the tibia, forefoot, and hallux segments. The FB data differed significantly for the majority of stance phase for sagittal tibia motion, all hindfoot planes, sagittal and coronal forefoot motion, and all hallux planes. The FB group kinematics also significantly differed throughout most of swing phase across all planes and segments, except coronal hindfoot motion. All FB kinematic data deviated further from control than the MB data except stance phase coronal tibia and transverse forefoot motion, where the data overlapped (Figure 1). Conclusion: Multi-segment foot and ankle gait kinematics following TAA showed the MB implant better restores healthy ambulatory motion than the FB implant. Abnormal stance phase kinematics lead to altered joint loading. This can accelerate adjacent joint arthritis, which has been seen following ankle arthrodesis.6 Both populations showed diminished forefoot plantarflexion throughout gait, compensating for decreased hindfoot dorsiflexion. Because the joints are not heavily loaded during swing phase, the primary concerns of alterations are regarding ground clearance and foot position prior to the next step. The MB implant better restores normal gait, minimizing compensations and likely decreasing arthritis-inducing stress on adjacent joints.

scholarly journals Medium-term results of the HINTEGRA total ankle arthroplasty

2020 ◽  
Vol 14 (3) ◽  
pp. 231-238
Author(s):  
Mohammadali Khademi ◽  
Paulo Ferrao ◽  
Nikiforos Saragas
Keyword(s):  
Case Series ◽  
Ankle Arthrodesis ◽  
Total Ankle Arthroplasty ◽  
Foot And Ankle ◽  
Medium Term ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
Secondary Objective ◽  
American Orthopaedic

Objective: The aim of this study was to determine patient satisfaction, survivorship, and revision rate of the HINTEGRA total ankle arthroplasty (TAA). Our secondary objective was to assess hindfoot function. Methods: All patients who underwent a HINTEGRA TAA between 2007 and 2014 were evaluated. We included a total of 69 patients (69 ankles), who were subjected to clinical and radiological examination and completed a visual analogue scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and the self-reported foot and ankle score (SEFAS). Hindfoot function was assessed using the AOFAS hindfoot score. Mean follow-up was 62 (57–101) months. Results: The mean VAS score was 2 (0–3) and the SEFAS was 37 (26–48) at the most recent follow-up, while the AOFAS ankle score improved from 57 (52–62) to 87 (82–93). The AOFAS hindfoot score improved from 82 to 92 postoperatively. Eight patients had periprosthetic osteolysis and 5 underwent bone grafting of cysts. We detected polyethylene and hydroxyapatite particles in specimens obtained from the cysts. Eight patients had their procedures converted to an ankle arthrodesis. Conclusion: In select patients, TAA improved quality of life. Our medium-term follow-up of the HINTEGRA TAA observed a survivorship of 89% at 5 years with an improvement in the AOFAS score and a mean SEFAS score of 37. We recommend that large periprosthetic cysts, which may be caused by the hydroxyapatite coating and polyethylene particles, be bone grafted prophylactically. We found hindfoot function to be preserved. Level of Evidence IV; Therapeutic Studies; Case Series.

Post-Fracture, Late Debridement Resection Arthroplasty of the Ankle

Foot & Ankle ◽  
1985 ◽  
Vol 6 (2) ◽  
pp. 70-82 ◽  
Author(s):  
Nathaniel Gould ◽  
A. Bart Flick
Keyword(s):  
Range Of Motion ◽  
Ankle Arthrodesis ◽  
Resection Arthroplasty ◽  
Total Ankle Arthroplasty ◽  
Ankle Arthroplasty ◽  
Type Of Surgery

Seven patients (three male and four female), aged 10 to 45 years (average, 36 years), who suffered fractures at the ankle (three right and four left) from 6 months to 20 years ago (average, 7.6 years), underwent late debridement resection arthroplasty. Follow-up ranged from 3.5 to 7 years (average, 5 years). Six patients improved in range of motion, endurance, and freedom from pain and swelling and were able to engage thereafter in increased activities, including sports. The oldest female (aged 45), because of continual pain 15 months later, had an ankle arthrodesis. No “normal” ankles resulted, but final rating determinations based on range of motion, endurance, swelling, pain, and subjective analyses were: excellent (1), good (3), fair (2), poor (1) (arthrodesis patient). Results of the 5-year follow-ups suggest that this type of surgery in selected cases is a feasible, at least interim, alternative to more radical total ankle arthroplasty or ankle arthrodesis.

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