Does Gender Influence the Outcomes of Total Ankle Arthroplasty in Patients with Ankle Osteoarthritis?

Complication Rates ◽

Foot And Ankle ◽

Ankle Osteoarthritis ◽

Ankle Arthroplasty ◽

Gender Influence ◽

Implant Survivorship ◽

Abstract Background Total ankle arthroplasty has progressed as a treatment option for patients with ankle osteoarthritis. However, no studies have been conducted to evaluate the effect of gender on the outcome. The purpose of the present study was to evaluate outcomes, survivorship, and complications rates of total ankle arthroplasty, according to gender differences. Methods This study included 187 patients (195 ankles) that underwent mobile-bearing HINTEGRA prosthesis at a mean follow-up of 7.5 years (range, 4 to 14). The two groups consisted of a men’s group (106 patients, 109 ankles) and a women’s group (81 patients, 86 ankles). Average age was 64.4 years (range, 45 to 83). Results Clinical scores on the Ankle Osteoarthritis Scale for pain and disability, and American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved and were not significantly different between the two groups at the final follow-up. There were no significant differences in complication rates and implant survivorship between the two groups. The overall survival rate was 96.4% in men and 93.4% in women at a mean follow-up of 7.5 years (p=0.621). Conclusions Clinical outcomes, complication rates, and survivorship of total ankle arthroplasty were comparable between men and women. These results suggest that gender did not seem affect outcomes of total ankle arthroplasty in patients with ankle osteoarthritis.

Does Gender Influence the Outcomes of Total Ankle Arthroplasty in Patients with Ankle Osteoarthritis?

10.21203/rs.3.rs-17831/v2 ◽

2020 ◽

Author(s):

Gun-Woo Lee ◽

Keun-Bae Lee

Keyword(s):

Mobile Bearing ◽

Complication Rates ◽

Ankle Osteoarthritis ◽

Ankle Arthroplasty ◽

Gender Influence ◽

Implant Survivorship ◽

The Difference ◽

Abstract Background: Total ankle arthroplasty has progressed as a treatment option for patients with ankle osteoarthritis. However, no studies have been conducted to evaluate the effect of gender on the outcome. The purpose of the present study was to evaluate outcomes, survivorship, and complications rates of total ankle arthroplasty, according to gender differences. Methods: This study included 187 patients (195 ankles) that underwent mobile-bearing HINTEGRA prosthesis at a mean follow-up of 7.5 years (range, 4 to 14). The two groups consisted of a men’s group (106 patients, 109 ankles) and a women’s group (81 patients, 86 ankles). Average age was 64.4 years (range, 45 to 83). Results: Clinical scores on the Ankle Osteoarthritis Scale for pain and disability, and American Orthopaedic Foot and Ankle Society ankle-hindfoot score improved and the difference was not statistically significant between the two groups at the final follow-up. There were no significant differences in complication rates and implant survivorship between the two groups. The overall survival rate was 96.4% in men and 93.4% in women at a mean follow-up of 7.5 years (p=0.621). Conclusions: Clinical outcomes, complication rates, and survivorship of total ankle arthroplasty were comparable between men and women. These results suggest that gender did not seem affect outcomes of total ankle arthroplasty in patients with ankle osteoarthritis.

The HINTEGRA total ankle arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.101b6.bjj-2018-1578.r1 ◽

2019 ◽

Vol 101-B (6) ◽

pp. 695-701 ◽

Cited By ~ 15

Author(s):

H-Y Yang ◽

S-H Wang ◽

K-B Lee

Keyword(s):

Functional Outcome ◽

Short Form ◽

Major Complication ◽

Mobile Bearing ◽

Range Of Movement ◽

Ankle Arthroplasty ◽

Implant Survivorship ◽

Aims The purpose of this study was to determine the functional outcome and implant survivorship of mobile-bearing total ankle arthroplasty (TAA) performed by a single surgeon. Patients and Methods We reviewed 205 consecutive patients (210 ankles) who had undergone mobile-bearing TAA (205 patients) for osteoarthritis of the ankle between January 2005 and December 2015. Their mean follow-up was 6.4 years (2.0 to 13.4). Functional outcome was assessed using the Ankle Osteoarthritis Scale, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, 36-Item Short-Form Health Survey (SF-36) score, visual analogue scale, and range of movement. Implant survivorship and complications were also evaluated. Results There were significant improvements in all functional outcome categories between the preoperative and final follow-up assessments (p < 0.001). Patients showed marked improvement in clinical outcomes in terms of pain, function, and quality of life. The overall implant survivorship was 91.7% at a mean follow-up of 6.4 years. In all, 33 major complications were identified with a 15.7% rate, resulting in 12 prosthesis failures (5.7%). Periprosthetic osteolysis (19 cases; 9.0%) was the most frequent complication. Conclusion Mobile-bearing TAA resulted in improved functional outcomes, a low major complication rate, and excellent implant survivorship at a mean follow-up of 6.4 years. Cite this article: Bone Joint J 2019;101-B:695–701.

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

10.1177/2473011420s00097 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0009

Author(s):

Assaf Albagli ◽

Susan M. Ge ◽

Patrick Park ◽

Dan Cohen ◽

E. Ruth Chaytor ◽

...

Keyword(s):

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.

Medium-term results of the HINTEGRA total ankle arthroplasty

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2020.v14.1198 ◽

2020 ◽

Vol 14 (3) ◽

pp. 231-238

Author(s):

Mohammadali Khademi ◽

Paulo Ferrao ◽

Nikiforos Saragas

Keyword(s):

Case Series ◽

Ankle Arthrodesis ◽

Foot And Ankle ◽

Medium Term ◽

Level Of Evidence ◽

Ankle Arthroplasty ◽

Secondary Objective ◽

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.

Effect of Travel Time and Distance on Outcomes in Total Ankle Arthroplasty

10.1177/2473011420s00154 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0015

Author(s):

Kristin C. Caolo ◽

Scott J. Ellis ◽

Jonathan T. Deland ◽

Constantine A. Demetracopoulos

Keyword(s):

Travel Time ◽

Complication Rate ◽

High Volume ◽

Complication Rates ◽

Linear Regression Models ◽

Ankle Arthroplasty ◽

Significant Difference ◽

Drive Time

Category: Ankle; Ankle Arthritis Introduction/Purpose: Surgeons who perform a higher volume of total ankle arthroplasty (TAA) are known to have decreased complication rates; evidence shows that low volume centers performing TAA have decreased survivorship when compared with high volume centers. Understanding differences in outcomes for patients traveling different distances for their TAA is important for future patients deciding where to travel for their surgery. No study has previously examined differences in outcomes of patients traveling different distances to a high volume center for their TAA. This study compares preoperative and postoperative PROMIS scores for patients undergoing total ankle arthroplasty who traveled less than and more than 50 miles for their TAA. We hypothesized that there would be no difference in outcome scores based on distance traveled or estimated drive time. Methods: This study is a single center retrospective review of 162 patients undergoing primary total ankle arthroplasty between January 2016 and December 2018. We collected the primary address as listed in the patient’s medical record and used the directions feature on Google Maps to estimate driving mileage and estimated driving time from the patient’s address to the hospital. To analyze the distance patients traveled, patients were divided into two groups: <50 miles traveled (n=91) and >50 miles traveled (n=71). To analyze the estimated drive time, patients were divided into two groups: <90 minutes (n=77), >90 minutes (n=85). We collected preoperative and most recent postoperative PROMIS scores for all patients. Differences in most recent post-operative PROMIS scores between distance groups and travel time groups were assessed using multivariable linear regression models, adjusting for the pre-operative score and follow-up time. Results: We found no significant difference in post-operative PROMIS scores between the two groups when analyzed for distance traveled or for estimated travel time after adjustment for pre-operative PROMIS score and follow-up time (Table 1). The average follow-up for all 162 patients was 1.49 years. Power analysis showed that with a sample size of 110 (55 in each group), we had 81% power to detect an effect size of 4. Patients saw an increase in their Physical Function scores and a decrease in their Pain Interference and Pain Intensity scores with postoperative scores better than population means (Table 1). Overall complication rate for the <50 miles group was 17.6%, 7.7% required surgery. The >50 miles group had an overall complication rate of 24.0%, 9.9% required surgery. Conclusion: Patients traveling further distances to a high volume orthopedic specialty hospital for their total ankle arthroplasty do not have different clinical outcomes than patients traveling shorter distances. This is particularly important for patients deciding where to have their total ankle arthroplasty surgery. Patients who travel further have the opportunity to be treated at a local academic center; however our results show that outcomes do not change when traveling further for total ankle arthroplasty. [Table: see text]

Axial Rotational Alignment of Mobile-Bearing Total Ankle Arthroplasty

10.1177/2473011419s00216 ◽

2019 ◽

Vol 4 (4) ◽

pp. 2473011419S0021

Author(s):

Beat Hintermann ◽

Lukas Zwicky ◽

Christine Schweizer ◽

Alexej Barg ◽

Roxa Ruiz

Keyword(s):

Tibial Component ◽

Mobile Bearing ◽

Axial Position ◽

Anterior Surface ◽

Ankle Arthroplasty ◽

Medial Border ◽

Wide Range ◽

Angle Of Rotation

Category: Ankle Arthritis Introduction/Purpose: In total ankle arthroplasty (TAA), component malpositioning is a major cause of implant failure, possibly due to the altered force patterns caused by the malpositioning which are then transmitted to the bone-implant interface or neighboring joints during physiological loading. Mobile-bearing TAA with their second interface, may allow the talus to adapt its position based upon the individual anatomy. However, no data exist on the change in component positioning after implantation. It is unclear whether it is the result of initial positioning during implantation or secondary adjustments such as possible soft tissue adaptions. We aimed to determine the relative axial rotation between the talar and tibial components at the end of surgery and after a minimum of 3 years follow-up. Methods: The relative rotation between the tibial and talar components was measured in two groups. First, intraoperatively before wound closure, in a consecutive series of 58 patients (60 ankles; age 61.8 [31 to 86] years; females 25, males, 35) who underwent TAA between February and November 2018. A K-wire inserted along the medial border of the tibial component and a rectangular marker positioned at the anterior surface of PE insert were used to determine the angle of rotation. Second, in 48 patients (48 ankles; age 60.2 [31 - 82] years; females, 24; males, 24) out of 1411 patients who underwent TAA between January 2003 and December 2015, and in whom a weight-bearing CT scan was taken for evaluation at 6.3 (range, 3.0 -16.3) years. The medial border of the tibial component and a perpendicular line to the anterior surface of the PE insert were used to determine the angle of rotation. Results: The angle of rotation, thus the relative position of the talar component compared to the tibial component, did not differ between the two groups (p = 0.2). While the talus was internally rotated by 1.7 (range, -14.0 - 14.0) degrees at the end of surgery, it was internally rotated by 1.5 (range, -13.0 – 19.5) degrees after a minimum follow-up of 3 years (Figure 1). Conclusion: Although there was no significant difference in average axial position measured intraoperatively compared to a 3- years follow-up, there was a wide range of rotational measurements. The possibility of the talar component to find its position as given by individual anatomy may be crucial in TAA to avoid non-physiological joint loads and shear forces which may otherwise result in increased PE wear. Due to the wide range of measurements, our data suggests that axial talar rotation cannot be predicted preoperatively or intraoperatively by surgical techniques that reference the transtibial axis, tibial tuberosity and transmalleolar axis as guidance for tibial component positioning.

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

Foot & Ankle International ◽

10.1177/1071100719866472 ◽

2019 ◽

Vol 40 (11) ◽

pp. 1273-1281 ◽

Cited By ~ 2

Author(s):

Gun-Woo Lee ◽

Asep Santoso ◽

Keun-Bae Lee

Keyword(s):

Short Form ◽

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.

A Comparison of Cyst Formation and Management in Mobile-Bearing and Fixed-Bearing Total Ankle Arthroplasty

10.1177/2473011419s00005 ◽

2019 ◽

Vol 4 (2) ◽

pp. 2473011419S0000

Author(s):

James Lachman ◽

Michel Taylor ◽

Elizabeth Cody ◽

Daniel Scott ◽

James A. Nunley ◽

...

Keyword(s):

Bone Grafting ◽

Patient Reported Outcomes ◽

Mobile Bearing ◽

Cyst Formation ◽

Fixed Bearing ◽

Ankle Arthroplasty ◽

Ankle Replacement ◽

Patient Reported

Category: Ankle Arthritis Introduction/Purpose: The Scandinavian Total Ankle Replacement(STAR) system and Salto Talaris(ST) total ankle system are two of the more commonly studied total ankle implants. As the STAR is one of the oldest total ankle arthroplasty (TAA) implants still in use today, most studies focus on longevity and survivorship. Reported rates of cyst formation for these two prosthesis in most series vary from 11-22% but no large study has focused on surgical management of these cysts or included patient reported outcomes after surgery. In this series, we aimed to investigate rates of cyst formation between mobile(MB) and fixed-bearing(FB) TAA and examine clinical and patient reported outcomes of bone grafting or cementing of large cysts surrounding the STAR and ST implants. Methods: A prospectively collected database at a high volume total ankle replacement center was retrospectively reviewed to identify patients who underwent TAA with either the STAR or the ST total ankle system between 2007 and 2015. Cysts were identified and measured on standard weight bearing radiographs and confirmed on computed tomography(CT) when available. Visual analog scale (VAS) score, Short Form-36 (SF-36) physical and mental component scores, Short Musculoskeletal Function Assessment(SMFA), and AOFAS hindfoot scores were collected from all patients preoperatively and then at 6 months, 1 year and annually postoperatively. Patients with a minimum 2 years follow-up who underwent revision TAA secondary to catastrophic bone cysts or who were managed with either curettage and bone grafting or curettage and cementing of bone cysts surrounding the TAA prosthesis were included in the patient reported outcomes (PRO) analysis Results: Excluding 53 patients for inadequate follow-up, 232 patients (29% female, 71% male; follow-up 6.7 years) who underwent STAR-TAA and 147 patients (26.6% female, 73.5% male; follow-up 7 years) who underwent ST-TAA were identified. Cysts <20 mm diameter occurred more often in the MB TAAs, and more often in the tibia than talus (table). Cysts >10 mm were identified in 95/232 (41%) STAR and 24/147 (16%) ST ankles. In the STAR group, 24 patients underwent cyst bone grafting (13), cementing (6) or both (8) at a mean 4.8 years. In the ST group, 14 patients underwent cyst bone grafting (6), cementing (4), or both (4) at a mean of 2.7 years. PRO data improved significantly for both the STAR and ST group in all questionnaires (p<0.05 for all). Conclusion: Mobile-bearing total ankle arthroplasty in this cohort had a higher rate of cyst formation greater than 10 mm (95/232 patients, 41%) when compared to a fixed-bearing TAA (24/147, 16.3%). Only 24/95 (25%) of STAR patients and 14/24 (58%) of ST patients required surgical intervention for cyst management. Patient reported outcomes after cyst surgery improved significantly when compared to pre-cyst management surgery and did not differ between MB and FB cohorts (p=0.424). Successful surgical management of large cyst surrounding either mobile-bearing or fixed-bearing total ankle systems can be expected based on the results of this study. [Table: see text]

Radiographic Outcomes of Mobile-Bearing Total Ankle Arthroplasty for Patients With Rheumatoid Arthritis

Foot & Ankle International ◽

10.1177/1071100719851469 ◽

2019 ◽

Vol 40 (9) ◽

pp. 1037-1042

Author(s):

Koichiro Yano ◽

Katsunori Ikari ◽

Ken Okazaki

Keyword(s):

Rheumatoid Arthritis ◽

Tibial Component ◽

Patient Reported Outcomes ◽

Mobile Bearing ◽

Ankle Arthroplasty ◽

Radiographic Outcomes ◽

Significant Difference ◽

Patient Reported

Background: Ankle disorders in patients with rheumatoid arthritis (RA) reduce their quality of life and activities of daily living. The aim of this study was to evaluate the midterm clinical and radiographic outcomes of TAA in patients with RA. Methods: This retrospective study included patients with a minimum follow-up of 2 years. A total of 37 RA patients (39 ankles) were enrolled in this study from August 2006 to March 2016. All the patients had undergone primary cemented mobile-bearing total ankle arthroplasty (TAA). Nine ankles received arthrodesis of the subtalar joint simultaneously. Patient-reported outcomes were measured preoperatively and at the latest follow-up by Self-Administered Foot-Evaluation Questionnaire (SAFE-Q). Radiographs of the ankle were analyzed preoperatively and at all follow-up visits to measure the periprosthetic radiolucent line, migration of the tibial component, and the subsidence of the talar component. Intraoperative and postoperative complications were recorded. The average duration of follow-up for the entire cohort was 5.0 ± 2.0 years (range 2.1-10.1 years). Results: All subscales of the SAFE-Q had improved significantly at the latest follow-up. No significant difference was found between the range of motion of the ankle before and after the surgery. Radiolucent lines were observed in 28 (73.7%) ankles. Migration of the tibial component and subsidence of the talar component were found in 8 (21.1%) and 11 (28.9%) ankles, respectively. Intraoperative malleolus fractures occurred in 3 (7.7%) ankles and delayed wound healing in 10 (25.6%) ankles. Four ankles were removed because of deep infection or noninfective loosening, resulting in an implant survival rate of 88.4% (95% CI, 0.76-1.0) at 10 years. Conclusion: The midterm patient-reported outcomes and implant retention rate after cemented mobile-bearing TAA for RA patients were satisfactory. However, a low radiographic implant success rate was observed. Level of Evidence: Level IV, retrospective case series.

Outcomes of Total Ankle Arthroplasty in Moderate and Severe Valgus Deformity

Foot & Ankle Specialist ◽

10.1177/1938640018785953 ◽

2018 ◽

Vol 12 (3) ◽

pp. 238-245 ◽

Cited By ~ 6

Author(s):

Constantine A. Demetracopoulos ◽

Elizabeth A. Cody ◽

Samuel B. Adams ◽

James K. DeOrio ◽

James A. Nunley ◽

...

Keyword(s):

Short Form ◽

Valgus Deformity ◽

Ankle Arthroplasty ◽

Short Musculoskeletal Function Assessment ◽

Sf 36 ◽

Patient Reported ◽

Musculoskeletal Function ◽

Introduction. Failure to correct coronal deformity at the time of total ankle arthroplasty (TAA) can lead to early implant failure. We aimed to determine clinical, radiographic, and patient-reported outcomes of patients with moderate to severe valgus deformity who underwent TAA for end-stage ankle arthritis. Methods. Patients with a valgus deformity of at least 10° who underwent TAA were retrospectively reviewed. The coronal tibiotalar angle was assessed on radiographs preoperatively, at 1 year, and at final follow-up. The visual analog scale (VAS) for pain, Short Form-36 (SF-36), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scale, and Short Musculoskeletal Function Assessment (SMFA) scores were assessed preoperatively and at final follow-up. Results. Mean preoperative valgus deformity was 15.5 ± 5.0°, and was corrected to a mean of 1.2 ± 2.6° of valgus postoperatively. VAS, SF-36, AOFAS, and SMFA scores improved significantly ( P < .001 for all). There was no significant change in tibiotalar angle between 1 year and final follow-up in either group. Reoperation and revision rates did not differ between groups. Conclusion. Correction of coronal alignment was achieved and maintained in patients with both moderate and severe preoperative valgus malalignment. Outcome scores significantly improved for all patients. Levels of Evidence: Therapeutic, Level IV