Clinical and Radiographic Outcomes of Revision Total Ankle Arthroplasty Using the INBONE II Prosthesis

Abstract

Background:The literature on the outcome of revision total ankle arthroplasty (TAA) remains limited. In this study, we aimed to report the clinical and radiographic outcomes of revision TAA at a high-volume center in the United Kingdom.Methods:This study was a retrospective review of 28 patients who underwent 29 revision TAAs using the INBONE II Total Ankle System (Wright Medical Technology/Stryker). Demographic, radiographic, and patient-reported outcome measure data were analyzed.Results:The mean duration from primary TAA to revision was 87.5 months (range, 16 to 223 months). The main indication for the revision was aseptic loosening after the primary TAA (83%). Additional procedures were required in 76% of ankles. At a mean follow-up of 40 months (range, 24 to 60 months), the infection rate was 7%, the reoperation rate was 7%, and the implant survival rate was 97%. A significant postoperative improvement in the radiographic component alignment measures was observed. The subsidence, loosening, and heterotopic ossification rates in this study were comparable with those in other reports and did not influence the clinical outcome. A significant improvement was observed in the Manchester-Oxford Foot Questionnaire (MOXFQ) in all domains and the EuroQol-5 Dimensions (EQ-5D) in 3 domains at 24 months postoperatively.Conclusions:Revision TAA using the INBONE II prosthesis was associated with good short-term survival and improvement in postoperative scores at 2 years. Maintenance of the postoperatively improved alignment was documented at the follow-up. The results of this study support the notion that revision TAA is a satisfactory option for failed primary TAA.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Comparison of Radiographic Talar Loosening Rates Between Salto-Talaris and INBONE II

“…Tibial subsidence was defined as more than 2 mm of implant displacement compared with previous radiographs, and talar subsidence was defined as more than 5 mm of implant displacement compared with previous radiographs in accordance with previous literature. 8 The decision was made to include subsidence of implants in the category of aseptic loosening given semantic overlap between these terms. Thus, the same parameters used to determine subsidence can be interchangeably applied to diagnose implant aseptic loosening.…”

Revision Total Ankle Arthroplasty Using the INBONE II System

“…The 92.0% (82.7%-100.0%) 3-year survivorship rate from reoperation and the 90.4% (80.8%-100.0%) 3-year survivorship rate from major complications reported in this series is comparable to previous literature. 14 The incidence of failed TAA is likely to increase despite substantial improvement in understanding of ankle biomechanics and implant design and instrumentation. Newer design systems including third-and fourth-generation TAA accounted for more than 80% of the index TAA in our series.…”

“…The 92.0% (82.7%-100.0%) 3-year survivorship rate from reoperation and the 90.4% (80.8%-100.0%) 3-year survivorship rate from major complications reported in this series is comparable to previous literature. 14…”

“…One recent study reported good short-term survival and improvement in a revision series using the INBONE II system. 14 However, this study included a relatively small series with short-term follow-up. Therefore, the purpose of this study is to describe the early initial results of revision TAA for presumed noninfected TAA failure using the INBONE II system with a larger sample size.…”

CORR Insights®: How Does a Novel In Situ Fixed-bearing Implant Design Perform in Revision Ankle Arthroplasty in the Short Term? A Survival, Clinical, and Radiologic Analysis

“…The revision tibial component subsided in seven of 18 of patients and the revision talus component subsided in 10 of 18 talar components. Subsidence was also seen at the talar component by greater than 5 mm in 29% (eight of 28) of patients in one published series [6]. Nonetheless, 97% of implants survived for at least 3 years.…”