Accuracy assessment of measuring component position after total ankle arthroplasty using a conventional method

Abstract

BackgroundThis study was to assess the accuracy of measuring the tibial and talar components position and to investigate the outlier rate of each component and predisposing factors related to component malalignment after total ankle arthroplasty (TAA) using a conventional method.MethodsOne hundred fifty consecutive primary total ankle arthroplasty were performed using the three-component HINTEGRA prosthesis for ankle end-stage osteoarthritis. Radiographic analysis for the accuracy of component position in coronal and sagittal plane was conducted at postoperative 6 months. Additionally, the accuracy of component position was evaluated according to presence of preoperative deformity or joint incongruency.ResultsThe mean postoperative coronal angles of the tibial and talar components (α and γ) were 91.9° and 91.3°. The mean postoperative sagittal angles of the tibial and talar components (β and δ angle) were 84.6° and 91.7°. In the coronal plane, 16 (10.7%) tibial components and 15 (10.0%) talar components showed outliers greater than 5°. In sagittal plane, 15 (10.0%) tibial components and 29 (19.3%) talar components showed outliers greater than 5°. There was no meaningful increase of the outlier rate regarding presence of preoperative deformity or joint incongruency.ConclusionsIn conventional method of TAA, the outlier rate of the tibial and talar components was about 10 to 20%, especially, the outlier rate of talar component in sagittal plane was up to 20%. Therefore, careful attention should be paid to implant the talar component in conventional TAA.

Syndesmotic Overload in 3-Component Total Ankle Replacement

“…12,15 Despite improvements in preoperative planning tools and instrumentation, restoring the ankle’s axis of rotation by resurfacing the tibial and talar surfaces remains challenging. 7,21,27 Over the past decade, mobile-bearing total ankles were introduced to the market and showed satisfactory outcomes. 2,3,5,9,10,30,33-35 Adding an interface between the polyethylene insert (PI) and the tibial component potentially permits motion between the talus and PI in both the sagittal and coronal planes and may allow rotational motion (axial plane).…”

Imaging of Total Ankle Arthroplasty: Normal Imaging Findings and Hardware Complications

“…96 Lee et al performed radiography immediately postoperatively, at 3 months, 6 months, 1 year, and then annually. 97 Immediate postoperative anteroposterior (AP) and lateral radiographs are helpful in determining whether the bones and orthopaedic implants are in expected alignment. They are also adequate in establishing a baseline alignment for future assessments.…”

“…However, they are performed without weightbearing, and attention to proper positioning will ensure these radiographs are useful as a comparison study for future examinations. 97 Subsequent studies are performed with AP and lateral weightbearing technique depending on patient tolerance, and some institutions include lateral non-weightbearing maximally dorsiflexed and plantarflexed images to assess the range of motion. 98 The subsequent studies are used to evaluate for signs of osteointegration, determine osseous and prosthetic component alignment, and detect developing heterotopic ossification, in addition to evaluating range of motion.…”

Does Gender Influence the Outcomes of Total Ankle Arthroplasty in Patients with Ankle Osteoarthritis?

“…[8][9][10][11][12][13][14][15][16][17] Various predisposing factors including age, gender, and preoperative deformity can affect the outcome of TAA. [9,11,[17][18][19][20][21] In related to gender difference, several studies demonstrated divergent clinical outcomes following total hip or total knee arthroplasty. In total hip arthroplasty, some studies reported no difference in all postoperative outcome measures between men and women.…”