Total ankle replacement

Abstract

We describe the medium-term results of a prospective study of 200 total ankle replacements at a single-centre using the Scandinavian Total Ankle Replacement. A total of 24 ankles (12%) have been revised, 20 by fusion and four by further replacement and 27 patients (33 ankles) have died. All the surviving patients were seen at a minimum of five years after operation. The five-year survival was 93.3% (95% confidence interval (CI) 89.8 to 96.8) and the ten-year survival 80.3% (95% CI 71.0 to 89.6). Anterior subluxation of the talus, often seen on the lateral radiograph in osteoarthritic ankles, was corrected and, in most instances, the anatomical alignment was restored by total ankle replacement. The orientation of the tibial component, as seen on the lateral radiograph, also affects the position of the talus and if not correct can hold the talus in an abnormal anterior position. Subtalar arthritis may continue to progress after total ankle replacement. Our results are similar to those published previously.

Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade

“…There were six studies that met the inclusion criteria for pooled data analysis of outcomes after total ankle arthroplasty (Table 2) [14–19]. Five of the studies were prospective and one was retrospective.…”

“…While first-generation implants were fraught with unacceptably high complication rates, current third-generation designs have led to more favorable outcomes [13–19]. Still, long-term survivorship of third-generation implants remains unknown.…”

Inferior Results of Salvage Arthrodesis After Failed Ankle Replacement Compared to Primary Arthrodesis

“…This can be achieved by adding surgeries (eg, osteotomies, ligament reconstructions) 2,6,7,10,12,21,24,35,37 or simple component exchange. 2,9,11,18,20,21,23,27,29,31,36,39 However, there will always be patients who are not amenable to this kind of treatment and conversion to an arthrodesis can be considered.…”

“…This can be achieved by adding surgeries (eg, osteotomies, ligament reconstructions) 2,6,7,10,12,21,24,35,37 or simple component exchange. 2,9,11,18,20,21,23,27,29,31,36,39 However, there will always be patients who are not amenable to this kind of treatment and conversion to an arthrodesis can be considered.While several studies investigated the radiographic and clinical outcomes after primary ankle arthrodesis, there is a paucity of reports available in the literature that deal with salvage arthrodesis after failed TAR. 2,3,[6][7][8]10,17,21,24,34,37 To the best of our knowledge there has been no comparative analysis performed to assess salvage arthrodesis after failed TAR and primary ankle arthrodesis.…”

Rheumatoid Arthritis and Total Ankle Joint Replacement

“…62 of the patients in the trial had an underlying diagnosis of rheumatoid arthritis. In a further paper from the same unit, Wood [10] demonstrated an impressive 80.3% survivorship with the STAR in 200 patients in whom the majority had rheumatoid arthritis. A total of 24 patients had required revision surgery.…”