Medium to long-term results of 130 Ankle Evolutive System total ankle replacements—Inferior survival due to peri-implant osteolysis

Koivu, Helka; Kohonen, Ia; Mattila, Kimmo; Löyttyniemi, Eliisa; Tiusanen, Hannu

doi:10.1016/j.fas.2017.03.016

Cited by 21 publications

(14 citation statements)

References 47 publications

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“…Harris et al (2014) studied 220 Rebalance prostheses, and similarly found encouraging early results. Some of the early models, such as AES, were withdrawn due to higher than expected complication rates (Di Iorio et al 2017, Koivu et al 2017b. Robust long-term follow-up results are important.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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“…4,5,19,25,32 However, similar to the AES prosthesis, results of the CCI compare unfavorably to other third-generation mobile- 7,18,21,28,30,37 and fixed-bearing implants 21 because of high complication rates and the formation of osteolytic cysts. 19,20,41 In our series, 45% of the reoperations performed were because of osteolytic cysts or loosening, which is comparable to other CCI studies. 26,37 Although no consensus on the cause of cyst development has been reached, wear debris seems to play a role.…”

Section: Discussionmentioning

confidence: 98%

Long-term Follow-up of 254 Ceramic Coated Implant (CCI) Evolution Total Ankle Replacements

Plaat²,

Sierevelt

et al. 2022

Foot Ankle Int.

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Background: The ceramic coated implant (CCI) Evolution was a third-generation implant design used in approximately 2000 total ankle replacements (TARs) between 2003 and 2016. Because this implant was abandoned, long-term follow-up studies are lacking. Methods: All patients undergoing TAR using a CCI prosthesis between 2004 and 2012 were included for analysis. Preoperatively the tibiotalar alignment was measured, and postoperatively the patients were followed up clinically, with radiographs and by questionnaire. The primary outcome was implant survival at 10 years of follow-up. Implant survival was also compared for (1) inflammatory joint disease vs noninflammatory joint disease and (2) preoperative tibiotalar neutral vs varus or valgus alignment. The secondary outcomes were complications, reoperations, and function (assessed by patient-reported outcome measures). Results: Two hundred fifty-four TARs were performed in 237 patients. Two hundred twelve additional procedures were performed to achieve stable ankles. At 10-year follow-up, the survival was 67.5%, with an average time to revision of 4.5 years. The 10-year survival of the inflammatory joint disease group was 76.8% and of the noninflammatory joint group 63.1% ( P = .44). In 248 TARs, the preoperative tibiotalar alignment was measured; (62% neutral, 25% varus, and 13% valgus), these showed 10-year survival rates of 74.7%, 48.2%, and 68.9% respectively ( P = .07). The complication rate was 54%; 37% of patients underwent reoperation. At a mean of 8.5 years, postoperative satisfaction scored an average of 7.0 (SD 2.26) on a 0- to 10-point numeric rating scale. The mean Foot and Ankle Ability Measure sports subscore was 24.7, the mean Foot and Ankle Outcome Score (FAOS) sports subscore was 42.8, and the mean 36-Item Short Form Health Survey score was 40.0. Regarding daily activities, the mean FAOS was 81.0. Conclusion: This is currently the sole study reporting the long-term results of the CCI prosthesis. The survival and functional outcomes were inferior to other third-generation mobile-bearing ankle implants.

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“…Periprosthetic cysts have been correlated with TAA failure when more than one-third of the bone implant interface is compromised or cortical lysis occurs, commonly reported with mobile-bearing prosthesis, nonanatomic designs, hydroxyapatite coating, and malalignment. 1,6,31,45 Koivu et al 35 reported that osteolysis was the reason for 75% of revision cases and 43% of failure cases in their review of 130 Ankle Evolutive System (AES; Biomet, Valence, France) replacements. Yang et al 59 reported in their series that periprosthetic cyst grafting was the most common indication for reoperation, with 19 of 210 (9%) Hintegra TAA requiring bone grafting.…”

Section: Introductionmentioning

confidence: 99%

CT Scan Assessment and Functional Outcome of Periprosthetic Bone Grafting After Total Ankle Arthroplasty at Medium-term Follow-up

2022

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Background Periprosthetic cysts can occur in up to 95% of total ankle arthroplasties (TAA) and have been correlated with implant failure. The aim of this study was to determine the clinical and radiologic outcomes, using computed tomographic (CT) scan, after periprosthetic cyst bone grafting and assess for the minimum cyst size that should be grafted. Methods A retrospective review was performed of all TAA procedures performed between 2007 and 2014 (n=93). A CT scan was done to assess cyst size and operative planning. Eight patients with 9 periprosthetic cysts larger than 1.75 cm3 were grafted and specimens sent for histology. The mean time to bone grafting was 7.3 (3.8-9.5) years. Functional outcome was assessed using the American Orthopaedic Foot & Ankle Society ankle score, visual analog scale, and Self-reported Foot and Ankle Score. A CT scan was performed at follow-up to assess graft incorporation and cyst size progression. The mean time to CT scan post grafting was 3.0 (0.7-4.7) years. Results There was no implant malalignment identified and no differences in the pre- and postoperative functional scores. Preoperatively cysts had a mean volume of 8.16 (2.04-14.03) cm3. The mean percentage incorporation was 89% (69%-100%). Eight of the grafted cysts were considered successful on CT, with the ninth having 69% incorporation. Five cysts were not grafted, as they were below 1.75 cm3, and remained the same size or had minimal enlargement. Conclusion The satisfactory results in this small cohort suggests that prophylactic bone grafting may extend implant survival. We recommend that periprosthetic cysts greater than 1.75 cm3 be prophylactically bone grafted, and that cysts smaller than 1.75 cm3 be monitored for progression in size. Level of Evidence: Level IV, Case Series.

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Medium to long-term results of 130 Ankle Evolutive System total ankle replacements—Inferior survival due to peri-implant osteolysis

Cited by 21 publications

References 47 publications

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

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

Long-term Follow-up of 254 Ceramic Coated Implant (CCI) Evolution Total Ankle Replacements

CT Scan Assessment and Functional Outcome of Periprosthetic Bone Grafting After Total Ankle Arthroplasty at Medium-term Follow-up

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