Comparison of Intermediate-term Outcomes of Total Ankle Arthroplasty in Primary and Ligamentous Post-traumatic Osteoarthritis

Abstract

Background: Ankle ligamentous injuries without fracture can result in end-stage ligamentous post-traumatic osteoarthritis, which may cause ligamentous imbalance after total ankle arthroplasty (TAA). However, outcomes of TAA in these patients are not well known. The purpose of this study was to evaluate intermediate-term clinical and radiographic outcomes of TAA in patients with ligamentous post-traumatic osteoarthritis and compare them with results of TAA for patients with primary osteoarthritis. Methods: We enrolled 114 patients (119 ankles) with consecutive primary TAA using HINTEGRA prosthesis at a mean follow-up duration of 6.0 years (range, 3-13). We divided all patients into 2 groups according to the etiology of osteoarthritis: (1) primary osteoarthritis group (69 ankles) and (2) ligamentous post-traumatic osteoarthritis group (50 ankles). Results: There was no significant intergroup difference in mean Ankle Osteoarthritis Scale (AOS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Short Form-36 Physical Component Summary, visual analog scale pain score, ankle range of motion, or complications at the final follow-up. However, the final tibiotalar angle was less corrected to 4.2 degrees in the ligamentous post-traumatic osteoarthritis group compared to 2.7 degrees in the primary osteoarthritis group ( P = .001). More concomitant procedures were required at the index surgery for the ligamentous post-traumatic osteoarthritis group ( P = .001). The estimated 5-year survivorship was 93.4% (primary osteoarthritis group: 91.3%; ligamentous post-traumatic osteoarthritis group: 95.8%). Conclusions: Clinical outcomes, complication rate, and 5-year survivorship of TAA in ankles with primary and ligamentous post-traumatic osteoarthritis were comparable with intermediate-term follow-up. Our results suggest that TAA would be a reliable treatment in ankles with ligamentous post-traumatic osteoarthritis when neutrally aligned stable ankles are achieved postoperatively. Level of Evidence: Level III, retrospective cohort study.

Total Ankle Arthroplasty for Posttraumatic Fracture Versus Primary Osteoarthritis: An Analysis of Complications, Revisions, and Prosthesis Survival

“…Similar studies are limited by mixed PTOA cohorts. 9 Similar to our study, Lee et al 15 found no difference in outcomes and 5-year implant survivorship (91.3% vs. 95.8%) in POA and instability PTOA, respectively. Nieuwe Weme et al 10 as well demonstrated no difference in outcomes or 6-year implant survivorship between fracture and instability PTOA (87% vs. 79%, respectively).…”

Long-Term Survival of HINTEGRA Total Ankle Replacement in 683 Patients

“…However, in a more comprehensive analysis, Gaugler et al found no association between age and revision risk or clinical outcomes following TAR 53 . As many authors have suggested, TAR should remain a treatment option for younger patients, provided that a higher physical demand on the implant as a potential risk factor is considered by the practitioner and the patient 22,[54][55][56] .…”

Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty

“…Total ankle arthroplasty (TAA) has been steadily developed while overcoming the drawbacks of the past and is widely performed as a primary treatment for end-stage ankle arthritis [ 1 – 9 ]. Wound closure is an important final step for good cosmesis and minimizing surgical site infection [ 10 ].…”