AKILE™ total ankle arthroplasty: Clinical and CT scan analysis of periprosthetic cysts

Hernandez, J. Lucas y; Laffenêtre, O.; Toullec, É.; Darcel, Véronique; Chauveaux, D.

doi:10.1016/j.otsr.2014.09.019

Cited by 15 publications

(3 citation statements)

References 35 publications

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“…In past literature, studies have demonstrated the superiority of conventional CT over conventional radiography (CR), suggesting that CR-based studies may not detect PPCs accurately. 1,32,39 Second, publications on cone-beam WBCT in the field of foot and ankle have recently demonstrated the superiority of 3D measurements over traditional two-dimensional (2D) CR-based ones. 17,35 This may suggest that the real alignment of the hindfoot may not be correctly assessed based on the conventional CR-CT sequence, particularly due to perspective distortion, which dramatically influences the value of the measured hindfoot alignment depending on the angle of rotation of the lower limb relative to the radiograph source, 3,5,41 and the absence of weightbearing in the case of conventional CT.…”

Section: Discussionmentioning

confidence: 99%

“…There is wide consensus regarding the higher accuracy of computed tomography (CT) versus conventional radiography (CR) in detecting and quantifying PPCs. 1,32,39 Nevertheless, because of the large amount of radiation, CT scans are usually recommended in the presence of progressive PPCs or suspected implant loosening, but not for regular follow-up. The recently introduced cone-beam weightbearing computed tomography (WBCT), characterized by a low radiation dose, 4 represents a valid and safe diagnostic alternative.…”

Section: Introductionmentioning

confidence: 99%

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3D, Weightbearing Topographical Study of Periprosthetic Cysts and Alignment in Total Ankle Replacement

et al. 2019

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Background: We investigated the association between hindfoot residual malalignment assessed on weightbearing computed tomography (WBCT) images and the development of periprosthetic cysts (PPCs) after total ankle replacement (TAR). We hypothesized that PPCs would be found predominantly medially in the varus configuration and laterally in the valgus configuration. Methods: Cases of primary TAR with available WBCT imaging of the ankle were included in this retrospective study. The location of the PPC was marked and the following volumes were calculated: total (TCV), medial (MCV), central (CCV), and lateral (LCV) cyst volumes. Hindfoot alignment was measured as Foot and Ankle Offset (FAO), with 95% confidence intervals (95% CIs) calculated to define varus (<95% CI) and valgus (>95% CI) groups. Cyst volumes were compared between these 2 groups. The American Orthopaedic Foot & Ankle Society (AOFAS) score at the time of the WBCT was also retrieved. Receiver operating characteristic (ROC) curves were used to determine FAO thresholds for predicting an increased risk of PPC. Results: Forty-eight TARs (mean follow-up, 44.6 months) were included, 81% of which had at least 1 PPC. The mean FAO was 0.12% (95% CI, –1.12 to 1.36). Patients with greater residual malalignment ( P < .001) and those with longer follow-up ( P < .001) presented with increased TCV. In varus cases, the MCV was greater than the LCV ( P = .042), with a threshold FAO value of −2.75% or less predicting an increased MCV. In valgus cases, the LCV was greater than the MCV ( P = .049), with a FAO threshold value of 4.5% or more predicting an increased LCV. Conclusion: In this series, the PPC volume after primary TAR significantly correlated with postoperative hindfoot malalignment and longer follow-up. Level of Evidence: Level III, retrospective comparative series.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

3D, Weightbearing Topographical Study of Periprosthetic Cysts and Alignment in Total Ankle Replacement

et al. 2019

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“…1 Studies have reported that up to 87% of lesions detected on CT scans had initial inaccurate radiographic interpretations. 24,26,33,47,60 We used CT scans to measure cyst size for operative decision making and planning and again at recent follow-up to assess cyst size progression, graft incorporation, and success.…”

Section: Discussionmentioning

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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The AES total ankle arthroplasty analysis of failures and survivorship at ten years

Iorio

Viste

Fessy

et al. 2017

International Orthopaedics (SICOT)

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AKILE™ total ankle arthroplasty: Clinical and CT scan analysis of periprosthetic cysts

Abstract: IV (retrospective case series).

Cited by 15 publications

References 35 publications

3D, Weightbearing Topographical Study of Periprosthetic Cysts and Alignment in Total Ankle Replacement

3D, Weightbearing Topographical Study of Periprosthetic Cysts and Alignment in Total Ankle Replacement

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

The AES total ankle arthroplasty analysis of failures and survivorship at ten years

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