High Rate of Osteolytic Lesions in Medium-Term Followup after the AES Total Ankle Replacement

Abstract

This study showed a high frequency of osteolysis in medium-term followup after the AES ankle replacement. The outcome was not sufficiently beneficial and we have discontinued use of this prosthesis.

Computed Tomography of Osteolysis Related to Total Ankle Replacement

“…The results were published in Journal of Bone and Joint Surgery British version at 2009 (Koivu et al 2009). Other reports with similar findings have been published afterwards (Besse et al, 2009;Besse et al, 2010;Kokkonen et al, 2011;Rodriguez et al, 2010). Alarming percentage of osteolysis has been reported with total ankle arthroplasty before (Doets et al, 2006;Knecht et al, 2004;Pyevich et al, 1998;Schutte & Louwerens, 2008;Su et al, 2004;Valderrabano et al, 2004;Wood & Deakin, 2003).…”

“…On radiographs osteolysis has been defined as a new or expanding sharply demarcated lucency adjacent to prosthesis components (Puri et al, 2002). Alarming reports regarding osteolytic lesions around AES total ankle prosthesis (Besse et al, 2009;Besse et al, 2010;Koivu et al, 2009;Kokkonen et al, 2011, Rodriquez et al, 2009) have increased interest in computed tomography in follow-up of total ankle prostheses.…”

“…Cahir et al (2007) and Keogh et al (2003) have shown the usefulness of CT in imaging painful hip after total hip replacement. Periprosthetic osteolysis and aseptic loosening are common complications after TAR (Berquist, 2006;Besse et al, 2009;Koivu et al, 2009;Kokkonen et al, 2011;Rodriguez et al, 2010). CT reveals osteolytic changes around prosthesis components in ankle better than radiographs (Besse et al, 2009;Hanna et al, 2007;Koivu et al, 2009;Rodriguez et al, 2009).…”

CORR Insights®: Can a Three-component Prosthesis be Used for Conversion of Painful Ankle Arthrodesis to Total Ankle Replacement?

“…We are just beginning to see long-term survival data for third generation primary total ankle joint replacements, so we should not expect to see long-term results for this newer technique at this time [2,3,9]. But caution is advised; early short-term successes with many ankle arthroplasty designs did not always lead to high rates of long-term survivorship [7,8].…”

In vivo kinematics and articular surface congruency of total ankle arthroplasty during gait

“…On the other hand, the survivorship still is not comparable to total knee and hip arthroplasty, primarily due to implant loosening and subsidence of the implant (Michael et al, 2008). Incidence of the osteolytic lesion or loosening of the implant varies greatly among implants, ranging from 4% (Buechel et al, 2004) to 100% (Kokkonen et al, 2011).…”