Comparison of Intermediate to Long-Term Outcomes of Total Ankle Arthroplasty in Ankles with Preoperative Varus, Valgus, and Neutral Alignment

Lee, Gun-Woo; Wang, Shaohua; Lee, Keun-Bae

doi:10.2106/jbjs.17.00703

Cited by 83 publications

(77 citation statements)

References 28 publications

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“…This is in line with the findings of Henricson and Ågren (2007) and further discussed by Coetzee (2008). However, Lee et al (2018) showed in their comparison of the survival rate on their 144 Hintegra patients that the long-term outcome was equally as good regardless of the preoperative alignment (up to 20°) as long as the postoperative alignment was neutral. Considering the non-standardized and retrospective radiographic set-up available in our study these results should be evaluated with care; nonetheless, optimal alignment of the prosthesis should logically reduce the possible factors that may lead to aseptic loosening and pain.…”

Section: Discussionsupporting

confidence: 87%

12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center

et al. 2020

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Background and purpose — Total ankle arthroplasties (TAAs) have larger revision rates than hip and knee implants. We examined the survival rates of our primary TAAs, and what different factors, including the cause of arthritis, affect the success and/or revision rate. Patients and methods — From 2004 to 2016, 322 primary Hintegra TAAs were implanted: the 2nd generation implant from 2004 until mid-2007 and the 3rd generation from late 2007 to 2016. A Cox proportional hazards model evaluated sex, age, primary diagnosis, and implant generation, pre- and postoperative angles and implant position as risk factors for revision. Results — 60 implants (19%) were revised, the majority (n = 34) due to loosening. The 5-year survival rate (95% CI) was 75% (69–82) and the 10-year survival rate was 68% (60–77). There was a reduced risk of revision, per degree of increased postoperative medial distal tibial angle at 0.84 (0.72–0.98) and preoperative talus angle at 0.95 (0.90–1.00), indicating that varus ankles may have a larger revision rate. Generation of implant, sex, primary diagnosis, and most pre- and postoperative radiological angles did not statistically affect revision risk. Interpretation — Our revision rates are slightly above registry rates and well above those of the developer. Most were revised due to loosening; no difference was demonstrated with the 2 generations of implant used. Learning curve and a low threshold for revision could explain the high revision rate.

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Section: Discussionsupporting

confidence: 87%

12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center

et al. 2020

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Section: Discussionmentioning

confidence: 86%

“…[32,33] We defined failure when either the tibial or talar metallic component was replaced. [19] Radiographic Evaluation…”

Section: Methodsmentioning

confidence: 99%

“…[8][9][10][11][12][13][14][15][16][17] Various predisposing factors including age, gender, and preoperative deformity can affect the outcome of TAA. [9,11,[17][18][19][20][21] In related to gender difference, several studies demonstrated divergent clinical outcomes following total hip or total knee arthroplasty. In total hip arthroplasty, some studies reported no difference in all postoperative outcome measures between men and women.…”

Section: Introductionmentioning

confidence: 99%

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

Lee

2020

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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.

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“…Lee et al reported that, regardless of preoperative deformity type or degree, if the tibiotalar angle of the ankle was corrected with any ligament imbalance or hindfoot deformity through an additional procedure, the TAA showed good outcomes. [19] The survivorship rate was not significantly different between men and women at a mean follow-up of 7.5 years (96.4% and 93.4%, respectively)(p=0.621) ( Figure 2). Gender had minimal effect on survival rates in TAA, perhaps attributable to the fact that there were no significant differences between the mean age at surgery (p=0.114) or failure rates (p=0.752) between men and women.…”

Section: Discussionmentioning

confidence: 89%

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

Lee

2020

Preprint

Self Cite

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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.

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Comparison of Intermediate to Long-Term Outcomes of Total Ankle Arthroplasty in Ankles with Preoperative Varus, Valgus, and Neutral Alignment

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 83 publications

References 28 publications

12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center

12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center

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

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

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