Better implant survival with modern ankle prosthetic designs: 1,226 total ankle prostheses followed for up to 20 years in the Swedish Ankle Registry

Undén, Alexandra; Jehpsson, Lars; Kamrad, Ilka; Carlsson, Åke; Henricson, Anders; Karlsson, Magnus K.; Rosengren, Björn

doi:10.1080/17453674.2019.1709312

Cited by 39 publications

(32 citation statements)

References 28 publications

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“…The survival rate of ankle implants was not included in our investigation, although this is an important outcome measure in ankle arthroplasty. Restoration surgery may lead to additional risks of infection, morbidity, and mortality, as well as further hospitalization and rehabilitation (30). All these impose a significant burden on health systems and the social economy.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of ankle arthroplasty on motor function recovery in patients with orthopedic ankle injury: a systematic review and meta-analysis

Tang¹,

Miao²,

Shu³

et al. 2022

Ann Palliat Med

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Background: This study analyzed the effects of ankle arthroplasty on the recovery of motor function in patients with orthopedic ankle injury.Methods: English databases including PubMed, Web of Science, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) examining the effects of ankle arthroplasty, ankle replacement, and joint prosthesis on motor function recovery in patients with orthopedic ankle injury. The outcome indicators included the American Orthopedic Foot and Ankle Society (AOFAS) score, the 36-item short form survey (SF-36) score, the Foot and Ankle Ability Measures (FAAM) score, and the visual analog scale (VAS) score. The quality of the included literature was evaluated using the Jadad tool, and meta-analysis of the experimental data was performed using the Review Manager 5.3 software.Results: A total of 7 articles, including 443 patients, were analyzed. The meta-analysis showed significant improvement in AOFAS scores among patients in the experiment group (who underwent ankle replacement) compared with those in the control group (who did not undergo ankle replacement) [mean difference (MD)

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Section: Discussionmentioning

confidence: 99%

The efficacy of ankle arthroplasty on motor function recovery in patients with orthopedic ankle injury: a systematic review and meta-analysis

Tang¹,

Miao²,

Shu³

et al. 2022

Ann Palliat Med

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“…It was agreed with a clinical study showing that BP implant with a longer stem was associated with a higher implant loosening rate and revision rate compared to Mobility implant. 36 However, a deep Journal of Orthopaedic Surgery 28(3) intramedullary stem with a height higher than 32 mm (such as INBONE II implant with extra cylindrical segments) was not investigated in this study due to the limit of the current model geometry, which may make a difference to the result and should be investigated in future studies. Both central keel type (such as Salto Talaris (Integra Lifesciences), Ankle Evolutive System (Zimmer Biomet, Warsaw, IN, US), and Agility (DePuy)) and parallel cylindrical bar type (such as STAR (Stryker), Box (MatOrtho Ltd, Leatherhead, Surrey, UK), trabecular metal total ankle (Zimmer Biomet)) fixation shared a similar biomechanical result and they had a lower micromotion compared with stem implants.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Finite-element analysis of the influence of tibial implant fixation design of total ankle replacement on bone–implant interfacial biomechanical performance

Zhang

Chen

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: Implant loosening in tibia after primary total ankle replacement (TAR) is one of the common postoperative problems in TAR. Innovations in implant structure design may ideally reduce micromotion at the bone–implant interface and enhance the bone-implant fixation and initial stability, thus eventually prevents long-term implant loosening. This study aimed to investigate (1) biomechanical characteristics at the bone–implant interface and (2) the influence of design features, such as radius, height, and length. Methods: A total of 101 finite-element models were created based on four commercially available implants. The models predicted micromotion at the bone–implant interface, and we investigated the impact of structural parameters, such as radius, length, and height. Results: Our results suggested that stem-type implants generally required the highest volume of bone resection before implantation, while peg-type implants required the lowest. Compared with central fixation features (stem and keel), peripherally distributed geometries (bar and peg) were associated with lower initial micromotions. The initial stability of all types of implant design can be optimized by decreasing fixation size, such as reducing the radius of the bars and pegs and lowering the height. Conclusion: Peg-type tibial implant design may be a promising fixation method, which is required with a minimum bone resection volume and yielded minimum micromotion under an extreme axial loading scenario. Present models can serve as a useful platform to build upon to help physicians or engineers when making incremental improvements related to implant design.

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“…107,115 Although overall revision rates have declined with newer generations of implants, the proportion due to loosening has remained the same. 107 In a single-institution study of more than 500 TARs with 7-year follow-up, 6.4% were revised due to implant failure, with loosening and talar subsidence as the most common culprits, accounting for 21% and 41% of the failures, respectively. 11 In the patient's history, implant loosening or subsidence may be associated with startup pain or mechanical pain with increased activity.…”

Section: Is There Subsidence/loosening?mentioning

confidence: 99%

Evaluating and Managing the Painful Total Ankle Replacement

et al. 2021

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The number of total ankle replacements (TARs) performed in the United States has dramatically increased in the past 2 decades due to improvements in implant design and surgical technique. Yet as the prevalence of TAR increases, so does the likelihood of encountering complications and the need for further surgery. Patients with new-onset or persistent pain after TAR should be approached systematically to identify the cause: infection, fracture, loosening/subsidence, cysts/osteolysis, impingement, and nerve injury. The alignment of the foot and ankle must also be reassessed, as malalignment or adjacent joint pathology can contribute to pain and failure of the implant. Novel advanced imaging techniques, including single-photon emission computed tomography and metal-subtraction magnetic resonance imaging, are useful and accurate in identifying pathology. After the foot and ankle have been evaluated, surgeons can also consider contributing factors such as pathology outside the foot/ankle (eg, in the knee or the spine). Treatment of the painful TAR is dependent on etiology and may include debridement, bone grafting, open reduction and internal fixation, realignment of the foot, revision of the implants, arthrodesis, nerve repair/reconstruction/transplantation surgery, or, in rare cases, below-knee amputation. Level of Evidence: Level V, expert opinion or review.

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Better implant survival with modern ankle prosthetic designs: 1,226 total ankle prostheses followed for up to 20 years in the Swedish Ankle Registry

Cited by 39 publications

References 28 publications

The efficacy of ankle arthroplasty on motor function recovery in patients with orthopedic ankle injury: a systematic review and meta-analysis

The efficacy of ankle arthroplasty on motor function recovery in patients with orthopedic ankle injury: a systematic review and meta-analysis

Finite-element analysis of the influence of tibial implant fixation design of total ankle replacement on bone–implant interfacial biomechanical performance

Evaluating and Managing the Painful Total Ankle Replacement

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