Short-Term Complications, Reoperations, and Radiographic Outcomes of a New Fixed-Bearing Total Ankle Arthroplasty

Saito, Guilherme Honda; Sanders, Austin; Netto, César de César; O’Malley, Martin J.; Ellis, Scott J.; Demetracopoulos, Constantine A.

doi:10.1177/1071100718764107

Cited by 51 publications

(57 citation statements)

References 33 publications

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“…Some studies report an ideal angle of 90° [10,13,15] and other studies report an ideal angle of 85° [2,9,20]. The mean postoperative tibiotalar angle of 90.1° is comparable to other studies, with a reported mean angle of 88.5° and mean deformity of 1.6° and 3° [2,10,23]. The mean talar alignment of 7.3 mm was in all cases translated anteriorly, which was also found by Choi, et al and Mann, et al [2,20].…”

Section: Resultssupporting

confidence: 78%

“…In literature reoperation procedures vary between 2.9% and 26% [1,2,9,10,13,14,20,[23][24][25]. In this study there were no revisions, which varies between 2.1% and 22.0% in other studies [1,10,11,13,14,20,[23][24][25]. However, the follow-up of the current study was rather short.…”

Section: Resultscontrasting

confidence: 48%

“…This could be caused by the removal of osteosynthesis material in 50% of the medial malleolar fractures. In literature reoperation procedures vary between 2.9% and 26% [1,2,9,10,13,14,20,[23][24][25]. In this study there were no revisions, which varies between 2.1% and 22.0% in other studies [1,10,11,13,14,20,[23][24][25].…”

Section: Resultssupporting

confidence: 42%

“…Tibiotalar alignment was determined as the angle between the mechanical axis of the tibia and a line tangential to the talar dome or talar prosthesis component ( Figure 3). The ideal angle is 90° with a range of 5° [23]. The talar alignment was determined as the anteroposterior position of the talus in relation to the longitudinal axis of the tibia (Figure 4).…”

Section: Resultsmentioning

confidence: 99%

“…The total ROM and clin- makes it hard to compare complication rates. Complications are categorized as intraoperative and postoperative [1,3,11,13,20,25], as minor and major [18,19,26], as high grade, medium grade, and low grade [2,10,23], or are not classified at all [2,9,12,14,16]. A further issue is heterogeneity in which events are counted as complications, for example HO is sometimes mentioned as complication and sometimes as radiological outcome.…”

Section: Resultsmentioning

confidence: 99%

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Short Term Results of the Cadence Total Ankle Prosthesis: A Dutch Non-Designer Case Series

Brylka¹,

Sierevelt²,

Vergroesen³

et al. 2020

Int J Foot Ankle

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CASE SErIES Check for updates caused by several factors including the ankle joint being difficult to mimic in a prosthesis due to movement in three planes, the constant moving rotational axis in the talus during dorsiflexion-plantarflexion movement, and tibia bone strength rapidly decreasing below the surface [5,6]. Also, the population undergoing TAR is relatively young and ankle osteoarthritis is mostly of secondary origin (i.e. posttraumatic) [3-6]. Furthermore, preoperative coronal plane deformities, common in lateral ligament instability and posttraumatic osteoarthritis, can be challenging to correct. Correction of these deformities is important since it influences the prosthesis survivorship. It can be corrected with techniques such as hindfoot arthrodesis, medial malleolar osteotomy or soft tissue balancing [7,8]. Additionally, TAR is a challenging procedure with a steep learning curve which influences survivorship and complication rates [3,9-12]. Complications associated with TAR are intraoperative malleolus fractures, tendon or nerve lacerations, heterotopic ossification, delayed wound healing, infection, and aseptic loosening [3,4,9-20]. There are still additional developments in TAR designs. The Cadence Total Ankle System (Integra Life-Sciences, Plainsboro, NJ) is a relative new ankle prosthesis introduced in 2016 [21]. To our knowledge, there are no published outcomes of the Cadence ankle prosthesis yet. Our hospital is the first in the Netherlands to use the Cadence prosthesis. Therefore, the aim of this study is to evaluate the short-term outcome of the

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Section: Resultssupporting

confidence: 78%

Section: Resultscontrasting

confidence: 48%

Section: Resultssupporting

confidence: 42%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Short Term Results of the Cadence Total Ankle Prosthesis: A Dutch Non-Designer Case Series

Brylka¹,

Sierevelt²,

Vergroesen³

et al. 2020

Int J Foot Ankle

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Biomechanical evaluation of total ankle arthroplasty. Part II: Influence of loading and fixation design on tibial bone–implant interaction

Gonzalez

Steineman

Sturnick

et al. 2020

Journal Orthopaedic Research

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Finite element (FE) models to evaluate the burden placed on the interaction between total ankle arthroplasty (TAA) implants and the bone often rely on peak axial forces. However, the loading environment of the ankle is complex, and it is unclear whether peak axial forces represent a challenging scenario for the interaction between the implant and the bone. Our goal was to determine how the loads and the design of the fixation of the tibial component of TAA impact the interaction between the implant and the bone. To this end, we developed a framework that integrated robotic cadaveric simulations to determine the ankle kinematics, musculoskeletal models to determine the ankle joint loads, and FE models to evaluate the interaction between TAA and the bone. We compared the bone-implant micromotion and the risk of bone failure of three common fixation designs for the tibial component of TAA: spikes, a stem, and a keel. We found that the most critical conditions for the interaction between the implant and the bone were dependent on the specimen and the fixation design, but always involved submaximal forces and large moments. We also found that while the fixation design influenced the distribution and the peak value of bone-implant micromotion, the amount of bone at risk of failure was specimen dependent. To account for the most critical conditions for the interaction between the implant and the bone, our results support simulating multiple specimens under complex loading profiles that include multiaxial moments and span entire activity cycles.

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Achilles tendon moment arm changes with total ankle arthroplasty

Wade

Hickox

Lewis

et al. 2020

Journal Orthopaedic Research

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Prior research on total ankle arthroplasty (TAA) has focused on improvements in pain and function following the surgical treatment of ankle arthritis, but its effect on ankle joint mechanics has received relatively little attention. The plantarflexion moment arm of the Achilles tendon is a critical determinant of ankle function with the potential to be altered by TAA. Here we investigate the effect of TAA on Achilles tendon moment arm assessed using two methods. Standing sagittal‐plane radiographs were obtained for ten patients presurgery and postsurgery, from which anterior–posterior distance between the posterior calcaneus and the center of the talar dome was measured. Ultrasound imaging and three‐dimensional (3D) motion capture were used to obtain moment arm pre‐ and post‐TAA. The absolute changes in moment arm pre‐ to post‐TAA were significantly different from zero for both methods (9.6 mm from ultrasound and 4.6% of the calcaneus length from radiographs). Only 46% of the variance in postoperative 3D Achilles tendon moment arm was explained by the preoperative value (r2 = 0.460; p = .031), while pre‐ and post‐TAA values from radiographs were not correlated (r2 = 0.192, p = .206). While we did not find significant mean differences in Achilles tendon moment arm between pre‐ and post‐TAA, we did find absolute changes in 3D moment arm that were significantly different from zero and these changes were partially explained by a change in location of the talar dome as indicated by measurements from radiographs (r2 = 0.497, p = .023).

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Short-Term Complications, Reoperations, and Radiographic Outcomes of a New Fixed-Bearing Total Ankle Arthroplasty

Abstract: Level IV, retrospective case series.

Cited by 51 publications

References 33 publications

Short Term Results of the Cadence Total Ankle Prosthesis: A Dutch Non-Designer Case Series

Short Term Results of the Cadence Total Ankle Prosthesis: A Dutch Non-Designer Case Series

Biomechanical evaluation of total ankle arthroplasty. Part II: Influence of loading and fixation design on tibial bone–implant interaction

Achilles tendon moment arm changes with total ankle arthroplasty

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