Early Experience With the CADENCE Total Ankle Prosthesis

Rushing, Calvin J.; Law, Rona; Hyer, Christopher F.

doi:10.1053/j.jfas.2020.08.023

Cited by 21 publications

(19 citation statements)

References 22 publications

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“…To our knowledge, there are only 2 other existing reports of outcomes after the total ankle replacement implant presented in this series. The first is Rushing et al’s 19 single-institution retrospective case series of 32 ankles with a minimum 1-year follow-up (mean, 24 months; range, 12-33 months). This study looked at clinical complications, reoperations, and radiographic alignment, cyst formation, and loosening.…”

Section: Discussionmentioning

confidence: 99%

Short-Term Complications and Outcomes of the Cadence Total Ankle Arthroplasty

et al. 2021

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Background: Total ankle arthroplasty (TAA) is an increasingly popular option for the operative treatment of ankle arthritis. The Cadence TAA entered clinical use in 2016 and was designed to address common failure modes of prior systems. We report early complications and radiographic and clinical outcomes of this total ankle system at a minimum of 2 years of follow-up. Methods: We performed a retrospective review of a consecutive cohort of patients undergoing primary Cadence TAA by a single surgeon from 2016 to 2017. Complications and reoperations were documented using the American Orthopaedic Foot & Ankle Society (AOFAS) TAA reoperation coding system. Patients completed the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sport subscales, SF-12 Mental (MCS) and Physical (PCS) Component Summaries, and visual analog scale (VAS) pain rating (0-100). Radiographic evaluation was performed to assess postoperative range of motion (ROM) of the sole of the foot relative to the long axis of the tibia, alignment, and implant complications. Results: Fifty-eight patients with a mean age of 63.3 years and mean body mass index of 31.9 kg/m2 were included. Twelve of 58 patients (20.7%) underwent an additional procedure(s) within 2 years, including 3 (5.2%) who required removal of one or both components, 2 for infection and 1 for osteolysis. Forty-three patients were followed for a minimum of 2 years with radiographic imaging; 1 patient’s (2.3%) radiographs had signs of peri-implant osteolysis, with no cases demonstrating loosening or subsidence. FAAM-ADL, FAAM-Sport, SF-12 PCS, and VAS pain scores all improved at a mean of 27.4 months postoperatively, with mean score changes (± SD) of 16.3 (± 22.0), 25.3 (± 24.5), 6.0 (± 11.1), and −32.3 (± 39.8), respectively. Radiographic analysis revealed that average coronal alignment improved from 6.9 degrees from neutral preoperatively to 2.3 degrees postoperatively. The average ROM of the foot relative to the tibia was 36.5 degrees total arc of motion based on lateral radiographs. Conclusion: Early experience with this 2-component total ankle replacement was associated with a high component retention rate, improved coronal plane alignment, good postoperative ROM, radiographically stable implants, and improved patient function. Level of Evidence: Level IV, case series.

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Section: Discussionmentioning

confidence: 99%

Short-Term Complications and Outcomes of the Cadence Total Ankle Arthroplasty

et al. 2021

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“…11 To date, 3 studies have investigated short-term outcomes of this new TAA system, reporting survivorship ranging from 93.7% to 100%, improved patient-reported outcomes, improved coronal alignment, and good postoperative range of motion. 8,23,32 However, all previous reports were either funded or investigated by inventors of the implant, which raises a need for non-industry funded research on this TAA system to support these early clinical and radiographic results.…”

Section: Introductionmentioning

confidence: 99%

Early Radiographic and Clinical Outcomes of a Novel, Fixed-Bearing Fourth-Generation Total Ankle Replacement System

et al. 2022

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Background: The Cadence Total Ankle System is a 2-component, fixed-bearing fourth-generation total ankle arthroplasty (TAA) system that was introduced for clinical use in 2016. The purpose of this study was to report non–inventor, non–industry funded survivorship, radiographic and clinical outcomes, and early complications following use of this implant at a minimum of 2 years. Methods: This single-center retrospective study included patients who underwent TAA by 2 surgeons with this novel fixed-bearing system between January 2017 and September 2018. Forty-eight patients were evaluated at an average of 33.6 months. Radiographic outcomes included preoperative and postoperative tibiotalar angle on anteroposterior radiographs of the ankle, sagittal tibial angle (STA) on lateral radiographs of the ankle, and periprosthetic lucency formation and location. Revision and reoperation data were collected, and patient-reported outcomes were assessed using Patient Reported Outcomes Measurement Information System (PROMIS). Subgroup analysis assessed associations between preoperative deformity, postoperative implant alignment, PROMIS scores, and periprosthetic lucency formation. Results: Survivorship of implant was 93.7%, with 3 revisions, 1 due to infection and 2 due to loosening of the implant (1 tibial and 1 talar component). Three patients had reoperations (6.3%): 2 for superficial infection and 1 for gutter debridement due to medial gutter impingement. Fifteen patients (35.8%) developed periprosthetic lucencies, all on the tibial side. PROMIS scores improved after surgery in all domains except Depression. Patients with significant postoperative periprosthetic lucency had worse postoperative PROMIS Physical function scores than patients without lucency ( P < .05). Conclusion: This study demonstrated excellent minimum 2-year clinical and radiographic outcomes and low revision and reoperation rates of this new fourth-generation TAA system. Future studies with longer follow-up, especially on patients with periprosthetic lucency, are necessary to investigate the long-term complications and understand the long-term functional and radiographic outcomes of this implant.

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“…The prosthesis is characterized by an anatomic-shaped bone-anchored talar component (cobalt chrome alloy) and a polyethylene meniscal insert attached to a bone-anchored tibial component (titanium alloy). 21,29 The articular surface pattern of talar dome is characterized by 2 condylar surfaces. 34 The lateral condyle of the talar dome has a larger radius of curvature compared with the medial condyle of the talar dome.…”

Section: Methodsmentioning

confidence: 99%

Decreased Mechanical Work Demand in the Chopart Joint After Total Ankle Replacement

et al. 2022

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Background: The success of total ankle replacement (TAR) must be based on restoring reasonable mechanical balance with anatomical structures that can produce mechanical joint work through elastic (eg, tendons, fascia) or viscoelastic (eg, heel pad) mechanisms, or by active muscle contractions. Yet, quantifying the work distribution across the affected joint and the neighboring foot joints after TAR is lacking. Therefore, the objective of this study was to investigate if there is a change in the joint work distribution across the Ankle, Chopart, Lisfranc and Metatarsophalangeal joints during level walking before and after patients undergo TAR. Methods: Fifteen patients with end-stage ankle osteoarthritis scheduled for primary TAR for pain relief were recruited and peer-matched with a sample of 15 control subjects. All patients underwent a 3D gait analysis before and after surgery, during which a kinetic multisegment foot model was used to quantify intersegmental joint work. Results: The contribution of the Ankle joint ( P = .007) to the total foot and ankle positive work increased significantly after TAR. In contrast, a significant decrease in the contribution to the total foot and ankle joint positive work ( P < .001) were found at the Chopart joint after TAR. The foot joints combined produced a significant increase in a net mechanical work from +0.01 J/kg before surgery to +0.05 J/kg after TAR ( P = .006). Conclusion: The findings of this study corroborate the theoretical rationale that TAR reduces significantly the compensatory strategy in the Chopart joint in patients with end-stage ankle osteoarthritis after TAR. However, the findings also showed that the contribution of the ankle joint of patients after TAR to the total foot and ankle joint positive work remained impaired compared to the control group.

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Early Experience With the CADENCE Total Ankle Prosthesis

Cited by 21 publications

References 22 publications

Short-Term Complications and Outcomes of the Cadence Total Ankle Arthroplasty

Short-Term Complications and Outcomes of the Cadence Total Ankle Arthroplasty

Early Radiographic and Clinical Outcomes of a Novel, Fixed-Bearing Fourth-Generation Total Ankle Replacement System

Decreased Mechanical Work Demand in the Chopart Joint After Total Ankle Replacement

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