Early Radiographic and Clinical Outcomes of a Novel, Fixed-Bearing Fourth-Generation Total Ankle Replacement System

Kim, Jaeyoung; Rajan, Lavan; Caolo, Kristin C.; Fuller, Robert; Henry, Jensen K.; Deland, Jonathan T.; Ellis, Scott J.; Demetracopoulos, Constantine A.

doi:10.1177/10711007221115185

Cited by 10 publications

(8 citation statements)

References 43 publications

(85 reference statements)

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“…Detailed analysis indicates that clinical, radiolographic ROM, implant position outcomes, and survival rate at an early-term follow-up of 2.9 years were similar to those reported with recent Cadence studies. 15,16,25,40 However, in contrast to previous reports, this study found an unanticipated serious adverse device effect of the Cadence prosthesis.…”

Section: Discussioncontrasting

confidence: 99%

“…15,16,28,40 These reported implant survival rates ranging from 93.7% to 100%, improved patient-reported outcome measures, good postoperative total arc motion (range of motion [ROM] assessed through the angle between the tibial axis and the sole of the foot) and improved coronal ankle alignment. 15,16,25,28,40 However, with the exception of the study by Kim et al, 25 all previous reports were investigated by the inventors of the prosthesis. The study reported in this article is a European, noninventor retrospective study reviewing a consecutive series of 60 Cadence TAR systems with a minimum of 2-year follow-up, focusing on clinical and radiographic outcomes and early complications.…”

Section: Introductionmentioning

confidence: 99%

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Early-Term Results of the Cadence Total Ankle Prosthesis: An European Noninventor Study

et al. 2022

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Background: Although considerable literature can be found on the outcome of total ankle replacement (TAR), only a few studies have reported the results of the fixed-bearing Cadence prosthesis. This noninventor study reports a consecutive series of 60 Cadence TAR systems with a mean of 2.9 years’ follow-up, focusing on clinical and radiographic outcomes and early complications. This study is the first to assess true postoperative radiographic ankle prosthesis range of motion (ROM) and to report an unanticipated serious adverse device effect. Methods: Sixty patients who underwent primary TAR with the Cadence prosthesis between July 2016 and July 2019 were clinically and radiographically evaluated preoperatively and at last follow-up after the procedure. Revisions, additional procedures, implant failure, and complications were reported according to the classifications of Vander Griend and Glazebrook. Radiographic outcomes included radiographic TAR ROM, bone-implant interface, and alignment parameters. Results: The survival rate of the prosthesis was 98.3%. The mean radiographic ankle ROM at the last follow-up was 24 degrees (9 degrees of dorsiflexion and 15 degrees of plantarflexion). The coronal and sagittal alignment of TAR was 90.8 degrees and 3.9 degrees, respectively. Bone-implant interface analysis revealed osteolysis in 9 ankles (15%) and radiolucent lines in 33 ankles (55%) occurring at both component interfaces. Intraoperative complications were 3 periprosthetic malleolar fractures (5%). Five talar implant fractures (implant failure of 8.3%) were observed, and 1 unexplained persistent pain that required a conversion from TAR to a tibiotalocalcaneal arthrodesis. Conclusion: Clinical, radiograph ROM, implant position outcomes, and survival rate at an early-term follow-up of 2.9 years were similar to those reported in recent Cadence studies. However, this study reports 5 unanticipated talar implant fractures and a high rate of posterior radiolucent lines. Level of evidence: Level IV,retrospective case series.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early-Term Results of the Cadence Total Ankle Prosthesis: An European Noninventor Study

et al. 2022

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“…Outcomes for this subgroup are often reported under the broader category of posttraumatic osteoarthritis, which includes patients with ligamentous origin as well. 4,6,7,12,13 Because these 2 posttraumatic ankle arthritis etiologies have different pathomechanisms, some studies have separately evaluated postfracture ankle arthritis, 2,5,19 consistent with our research question. Nieuwe Weme et al 19 reported comparable patient-reported outcome scores and survivorship between postfracture ankle arthritis and instability arthritis patients at a mean follow-up of 5 years after undergoing mobile-bearing TAA.…”

Section: Discussionmentioning

confidence: 76%

Outcomes of Total Ankle Arthroplasty in Postfracture Ankle Arthritis

Kim,

Radkievich,

Mizher

et al. 2023

Foot Ankle Int.

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Background: Ankle arthritis that develops after fracture accounts for a significant portion of ankle arthritis necessitating total ankle arthroplasty (TAA). It remains unknown whether TAA in postfracture patients produces equivalent outcomes to those without fracture history. The purpose of this study was to evaluate the medium-term outcomes of TAA in postfracture ankle arthritis compared to those without fracture history. Methods: This study reviewed 178 ankles from 171 consecutive patients who underwent TAA in our institution between 2007 and 2017 and completed a minimum 5-year follow-up. Four different TAA systems were utilized by 6 surgeons. Based on fracture history, patients were divided into 2 groups: the postfracture group (n = 63; median age 65.7 years; median follow-up 5.9 years) and the nonfracture group (n = 115; median age 64.4 years; median follow-up 6.2 years). Types and rates of complications including revision and reoperation were compared. Minimum 5-year Foot and Ankle Outcome Score (FAOS) and postoperative improvement were investigated. A subgroup analysis was performed to determine whether outcomes differ between intraarticular fracture patients (n = 43) and extraarticular fracture patients (n = 20). Results: Both groups exhibited comparable postoperative improvement and final FAOS scores. The postfracture group had a significantly higher reoperation rate than the nonfracture group (20 of 63, 31.7%, vs 17 of 115, 14.8%; P = .011), with gutter impingement being the most common cause. There were 3 revisions in each group. In the subgroup analysis, we found no evidence of statistical difference between the intraarticular fracture group and the extraarticular fracture group in terms of FAOS scores, revision, and reoperation rates. Conclusion: In this single-center, retrospective comparative study, we found total ankle arthroplasty in patients with a history of fractures around the ankle joint had no evidence of statistical difference in patient-reported outcomes and implant survivorship but led to a higher rate of nonrevision reoperation following surgery. In the much smaller subset of patients with previous fracture, we did not find that those with a history of intraarticular fracture had inferior outcomes after TAA when compared to those with a history of extraarticular fracture. Level of Evidence: Level III, case-control study.

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“…In this study, the incidence of tibial lucency (21.5%) is comparable to rates reported in some other fixed-bearing implants, which range between 20.9% and 38.0%. 15,19,20 Moreover, when comparing radiolucencies reported at 2-year follow-up to 5-year radiographs, 37.5% of the radiolucencies had resolved, 37.5% were still present, and 25% had progressed but remained asymptomatic. It is unclear why the lucencies resolved in some patients and not others, and we did not observe any change in the alignment of the components or subsidence of the implants.…”

Section: Discussionmentioning

confidence: 99%

Midterm Clinical Outcomes, Radiographic Outcomes, and Survivorship of the Infinity Total Ankle Arthroplasty

Shaffrey,

O’Malley,

Henry

et al. 2023

Foot Ankle Int.

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Background: The Infinity Total Ankle Arthroplasty (Stryker, Mahwah, NJ) is a low-profile fixed-bearing implant first introduced in 2014. Although the short-term survivorship (2-4 years follow-up) and complication rates of the Infinity TAA have been reported, there are limited midterm outcome reports. The aim of this study was to describe the survivorship and clinical outcomes of a single-center experience with the Infinity implant at minimum 5-year follow-up. Methods: Retrospective review of 65 ankles that underwent primary total ankle arthroplasty (TAA) with the Infinity implant was conducted. Mean clinical follow-up was 6.5 years (range, 5.0-8.0). Preoperative and postoperative radiographs were measured to assess tibiotalar alignment, periprosthetic lucencies, and cysts. Preoperative, 2-year, and 5-year postoperative Foot and Ankle Outcome Score (FAOS) subscores were compared to assess midterm clinical outcomes. Survivorship assessment was determined by removal of 1 or both metallic implant components. Results: Survivorship of the implant was 93.8% at final follow-up. There were 4 revisions: 2 for tibial implant loosening, 1 for talar loosening, and 1 for loosening of both components. Three of the 4 revisions occurred within the first 2 years following implantation, and the last failure occurred at 7 years postoperatively. There were 11 reoperations in 10 (15%) ankles and 3 wound complications. There were 17 ankles (26.2%) with radiographic abnormalities around the implants, including 14 cases with tibial component lucencies and 4 cases of periimplant cysts. FAOS outcome measurement showed general stability between 2 and 5 years and substantial improvement from preoperative status. Conclusion: To date this study is the largest midterm report on the Infinity total ankle prosthesis, with 65 implants at a mean follow-up of 6.5 years. We found good midterm implant survivorship, and patients experienced significant improvements in FAOS outcome scores and radiographic alignment at final follow-up. Level of Evidence: Level III, retrospective cohort study.

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Early Radiographic and Clinical Outcomes of a Novel, Fixed-Bearing Fourth-Generation Total Ankle Replacement System

Cited by 10 publications

References 43 publications

Early-Term Results of the Cadence Total Ankle Prosthesis: An European Noninventor Study

Early-Term Results of the Cadence Total Ankle Prosthesis: An European Noninventor Study

Outcomes of Total Ankle Arthroplasty in Postfracture Ankle Arthritis

Midterm Clinical Outcomes, Radiographic Outcomes, and Survivorship of the Infinity Total Ankle Arthroplasty

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