Long-term follow-up of mobile-bearing total ankle replacement in patients with inflammatory joint disease

Abstract

Little is known about the long-term outcome of mobile-bearing total ankle replacement (TAR) in the treatment of end-stage arthritis of the ankle, and in particular for patients with inflammatory joint disease. The aim of this study was to assess the minimum ten-year outcome of TAR in this group of patients. We prospectively followed 76 patients (93 TARs) who underwent surgery between 1988 and 1999. No patients were lost to follow-up. At latest follow-up at a mean of 14.8 years (10.7 to 22.8), 30 patients (39 TARs) had died and the original TAR remained in situ in 28 patients (31 TARs). The cumulative incidence of failure at 15 years was 20% (95% confidence interval (CI) 11 to 28). The mean American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score of the surviving patients at latest follow-up was 80.4 (95% CI 72 to 88). In total, 21 patients (23 TARs) underwent subsequent surgery: three implant exchanges, three bearing exchanges and 17 arthrodeses. Neither design of TAR described in this study, the LCS and the Buechel-Pappas, remains currently available. However, based both on this study and on other reports, we believe that TAR using current mobile-bearing designs for patients with end-stage arthritis of the ankle due to inflammatory joint disease remains justified.

Mid‐ to long‐term results of total ankle replacement in patients with haemophilic arthropathy: A 10‐year follow‐up

“…As haemophilic arthropathy and inflammatory joint disease share some pathophysiological aspects, comparison seems particularly applicable. In the light of this, the present study's 15‐year implant survival of 70% nearly accords with the 73% reported by Kraal et al who examined 93 cases of TAR in inflammatory joint disease. Bartel et al reported 5‐ and 10‐year survival rates of 87% and 81% (vs 94% and 85%), based on data of all 6 listed national joint registries including 5152 primary TARs in general populations.…”

“…Corresponding studies reporting long‐term outcomes in haemophiliacs are missing. However, the here reported long‐term survival is comparable both to the results in patients with inflammatory joint disease and to the results in a general population. As haemophilic arthropathy and inflammatory joint disease share some pathophysiological aspects, comparison seems particularly applicable.…”

In-Patient Trends and Complications After Total Ankle Arthroplasty in the United States

“…24,25,31 Other common complications quoted in literature include infections (3.2% to 13%), wound healing issues (1.6% to 14%), and postsurgical pain (2% to 4%). [6][7][8][9][23][24][25][26][27][28][29][30][31] Although these complications are not reflected in the current study, they are common reasons for readmission.…”

Incidence of Revision After Primary Implantation of the Salto® Mobile Version and Salto Talaris™ Total Ankle Prostheses: A Systematic Review

“…Taken collectively, total ankle replacement requires precise implantation because mobile-bearing UHMWPE inserts or more incongruity between the fixed-bearing UHMWPE insert and talar component geometry are incapable of predictably accommodating appreciable malalignment. Finally, the withdrawal in 2009 of the B€ uechel-Pappas total ankle system (Endotec, South Orange, NJ) (83), which was the predicate mobilebearing design and had good 20-year patient outcomes and survivorship (84), combined with the good 14-year patient outcomes and survivorship with the ESKA fixed-bearing total ankle (GmbH & Co, L€ ubeck, Germany) (85), and lack of clinically significant differences in outcomes or survivorship between mobile-and fixed-bearing prosthesis types (16) indicates that the bearing type should not be the main criteria for surgeon adoption of a particular prosthesis.…”