In the past few decades, total ankle replacement (TAR) has become the backbone of treatment for end-stage ankle osteoarthritis, with improving outcomes. The aim of the present study was to present the long-term survival of the HINTEGRA TAR. This single-center retrospective cohort study included 722 ankles in 683 patients who underwent HIN-TEGRA TAR for end-stage ankle osteoarthritis. We performed a survival analysis and assessed potential risk factors. Clinical outcomes and patient satisfaction were determined. The cumulative survival rate was 93% (95% confidence interval [CI], 91% to 95%) at 5 years, 86% (95% CI, 83% to 88%) at 10 years, and 82% (95% CI, 78% to 85%) at 15 years. Aseptic loosening was the most common reason for revision, accounting for 54 (43%) of 126 revision procedures. A secondary etiology was associated with a lower risk of revision than primary or posttraumatic. The HINTEGRA TAR results in desirable long-term implant survival with an acceptable revision rate. Coronal-plane instability must be evaluated and addressed at the time of the index surgery.
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