Impact of Complications in Total Ankle Replacement and Ankle Arthrodesis Analyzed with a Validated Outcome Measurement

Introduction Total ankle arthroplasty is increasingly used as an alternative to arthrodesis to treat advanced ankle arthritis. However, the outcomes and postoperative complications are poorly described. Patients and methods Between March 2005 and May 2010 114 S.T.A.R. prostheses were implanted by one surgeon at our institution. We retrospectively analysed the demographics, clinical outcomes and radiographic characteristics of 100 ankle prostheses (97 patients).Results The average follow up was 36 months. The average preoperative AOFAS score of 36.87 (22-58) significantly increased to 75.99 postoperative. A total of 87 % of the patients reported a better life quality. Twenty-seven ankles incurred complications after primary surgery, and 21 prostheses required revision surgery, including four patients who required arthrodesis. Conclusion Our study shows a high satisfaction rate after total ankle replacement and clear pain relief. Patients with a body mass Index higher than 30 showed a higher rate of complications. Compared with ankle fusion, the rates of complications are comparable.

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“…On the other hand studies performed recently show a similar complication rate between ankle fusion and ankle replacement [13,[17][18][19].…”

Section: Discussionmentioning

confidence: 52%

“…Furthermore, ankle fusion has a complication rate up to 60 %. The main reasons for revision following arthrodesis are nonunion, malunion, infection and wound complications [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Complication rates after total ankle arthroplasty in one hundred consecutive prostheses

Noelle

Egidy

Cross

et al. 2013

International Orthopaedics (SICOT)

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“…For joint replacement it was suggested that functional results may approximate those of healthy subjects [7], which seemed to be the most powerful arguments for the choice of an arthroplasty in comparison to an arthrodesis despite higher complication and reoperation rates [15,16]. Nevertheless, comparative studies showed that neither group functioned as well as normal subjects [8,9,11,17].…”

Section: Discussionmentioning

confidence: 99%

Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle arthroplasty over arthrodesis

Braito

Dammerer

Kaufmann

et al. 2014

International Orthopaedics (SICOT)

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Purpose Prior studies have reported improved gait performance and kinematics after total ankle arthroplasty (TAR) compared to ankle arthrodesis (AAD). Given these findings, AAD has been primarily considered as a salvage procedure that may lead to adjacent joint degeneration. Methods A total of 101 TAR and 40 screw arthrodeses were enrolled in a retrospective study with a prospectively designed follow-up examination that included gait analysis and outcome assessment with the AOFAS hindfoot score and FAOS questionnaire. Results Significant asymmetry in gait and reduced range of motion compared to normal remained after both procedures. Subjective outcome improved after both procedures, and pain was significantly better after TAR. Limited functional gains after TAR and joint degeneration to the same degree after both procedures was seen in the mid-term. Hindfoot fusion seemed to have a greater impact on postoperative function than ankle arthrodesis. Conclusion Considering only minor functional gains of TAR compared to AAD the implantation of current TAR designs in large patient series may be questioned.

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“…Peripheral neurologic injury is an important complication following ankle arthroplasty, but its incidence is thought to be uncommon [1][2][3][4][5][6][7]. For lower limb arthroplasty, the common mechanisms related to neurologic injuries include traction, compression, entrapment, direct laceration, and indirect trauma [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies reported the incidence of peripheral neurologic injuries in patients who underwent total ankle arthroplasty to be between 1.8 and 21 % of all cases, and these were found to be related to several causes [1,10,[19][20][21][22][23]. Lee at al.…”

Section: Introductionmentioning

confidence: 99%

Neurologic injuries after primary total ankle arthroplasty: Prevalence and effect on outcomes

Kim¹,

Primadhi

Lee³

2017

Foot and Ankle Surgery

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Background: Neurologic injuries are complications that can arise after total joint arthroplasty. However, no comprehensive study has been conducted on peripheral nerve injuries after total ankle arthroplasty. The purpose of the present study was to identify the prevalence of neurologic injury following primary total ankle arthroplasty, the predisposing factors, and evaluate the effect on clinical outcomes. Methods: We retrospectively analyzed 150 consecutive primary total ankle arthroplasty using the mobile-bearing prosthesis between January 2005 and December 2011, in 150 patients with symptomatic ankle end-stage arthritis. All the patients were divided into groups according to whether they had postoperative peripheral neuropathy (23 patients) or not (127 patients). We investigated the prevalence, predisposing factors, and effect on clinical outcomes of neurologic injuries. The mean age was 61.3 years, and the mean follow-up period was 41.8 months.Results: There were 23 nerve injuries (15.3 %), including nine in posterior tibial nerves, six superficial peroneal nerves, six deep peroneal nerves, one saphenous nerve, and one sural nerve. Neurologic injury was significantly associated with the development of posttraumatic osteoarthritis, but it was not significantly associated with other predisposing factors, such as age, gender, body mass index, and symptom duration. Of the 23 nerve injuries, 13 (56.5 %) presented a complete, spontaneous recovery, 9 (39.1 %) presented an incomplete recovery, and 1 (4.3 %) presented no recovery. The patients with neurologic injury had significantly lower American Orthopaedic Foot and Ankle Society scores and lower levels of patient satisfaction. Conclusions:The results of this study suggest that the prevalence of neurologic injury after total ankle arthroplasty is considerable, and that neurologic injury is associated with low levels of patient satisfaction and poor clinical outcomes at mean of 3 years, postoperatively. Care is needed to reduce the occurrence of neurologic injuries.

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Impact of Complications in Total Ankle Replacement and Ankle Arthrodesis Analyzed with a Validated Outcome Measurement

Cited by 137 publications

References 46 publications

Complication rates after total ankle arthroplasty in one hundred consecutive prostheses

Complication rates after total ankle arthroplasty in one hundred consecutive prostheses

Are our expectations bigger than the results we achieve? A comparative study analysing potential advantages of ankle arthroplasty over arthrodesis

Neurologic injuries after primary total ankle arthroplasty: Prevalence and effect on outcomes

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