Intermediate and Long-Term Outcomes of Total Ankle Arthroplasty and Ankle Arthrodesis

Haddad, Steven L.; Coetzee, J. N.; Estok, Rhonda; Fahrbach, Kyle; Banel, Deirdre; Nalysnyk, Luba

doi:10.2106/00004623-200709000-00002

Cited by 561 publications

(132 citation statements)

References 4 publications

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“…The clinical outcome in terms of the American Orthopaedic Foot and Ankle Surgeons' score and range of motion data were comparable both with published series of the STAR implant [1,21] and the results of meta-analysis of combined data [9]. It is our observation that the rehabilitation time following surgery is prolonged with slow but progressive improvement in the range of movement and reduction in discomfort and swelling.…”

Section: Discussionsupporting

confidence: 80%

“…The remaining three underwent successful fusion, which is an effective salvage procedure after failed total ankle arthroplasty [5]. This corresponds to a fusion rate of 6% (3/48), which is comparable to the 5% (29/572) conversion rate to fusion reported in a recent meta-analysis of total ankle arthroplasty [9]. We observed survival of 90% at 5 years and 84% at 8 years with a revision rate of 17%.…”

Section: Discussionsupporting

confidence: 73%

“…These figures are comparable to other series of the STAR in particular [1,21] and ankle replacement prostheses in general [8,11,13] ( Table 3). The above-mentioned meta-analysis quoted a 5-year survival of 78% and a 10-year survival rate of 77% for ankle arthroplasty, with an overall revision rate of 7% [9]. We suspect the survival figure will continue to improve with better case selection, attention to operative detail and correction of any residual deformity or instability.…”

Section: Discussionmentioning

confidence: 95%

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The Scandinavian Total Ankle Replacement: Survivorship at 5 and 8 Years Comparable to Other Series

Karantana

Hobson

Dhar

2010

Clinical Orthopaedics &Amp; Related Research

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Ankle arthroplasty is increasingly used to treat advanced ankle arthritis. Earlier prostheses have given way to second-generation implants, on which we are accumulating medium-term data. The Scandinavian Total Ankle Replacement (STAR) is a three-component uncemented implant in wide use in Europe and the only mobile-bearing prosthesis with conditional approval in the United States. We retrospectively reviewed 45 patients (52 ankles) who had primary total ankle replacements using STAR prostheses, in order to assess survivorship and add to the pool of clinical data provided by independent practitioners required to establish this treatment as a viable alternative to arthrodesis. The minimum followup was 60 months (range, 60-110 months). Clinical outcome was determined using the AOFAS score. We determined the rate of radiographic loosening and recorded complications and the need for further surgery. Survival was 90% (95% CI 76.8 to 95.5) at 5 years and 84% (95% CI 68.9 to 92.2) at 8 years. Six of 52 ankles (11%) had component revision and two were converted to fusion. The mean postoperative AOFAS score was 78. The complication rate was 21%. Subsequent surgery, excluding component revision, was performed in nine of 52 (17%) ankles.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 95%

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The Scandinavian Total Ankle Replacement: Survivorship at 5 and 8 Years Comparable to Other Series

Karantana

Hobson

Dhar

2010

Clinical Orthopaedics &Amp; Related Research

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“…We found the cumulative incidence of revision for any reason was 19% (four ankles). These results are comparable to those reported in other studies [11,36]. However, at the latest followup, both prosthesis components were radiographically stable, so that no component exchange was necessary during the study duration.…”

Section: Discussionsupporting

confidence: 89%

“…One study reported five TAAs in four patients with HH [6] and showed all four patients had good relief of symptoms after surgery. Although TAA is becoming more commonly used, the relative benefits of TAA continue to be one of the most debated topics in foot and ankle surgery [11]. First, there is a steep learning curve associated with performing TAA [20,27,31,35].…”

Section: Introductionmentioning

confidence: 99%

Total Ankle Arthroplasty in Patients with Hereditary Hemochromatosis

Barg

Elsner

Hefti

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background More than half of patients with hereditary hemochromatosis (HH) have painful arthritis, often including hindfoot osteoarthritis. Total ankle arthroplasty (TAA) is increasingly recommended for patients with painful ankle osteoarthritis. However, the pain relief and function experienced by patients continues to be debated particularly as compared with ankle fusion. Questions/purposes We asked whether (1) the complication rates were low; (2) the components were stable; (3) the patients achieved pain relief; and (4) the patients had satisfactory midterm function, ROM, and quality of life. Patients and MethodsWe retrospectively reviewed all 16 prospectively followed patients (21 implants) with HH who underwent ankle arthroplasty. They had an average age of 59.5 years at the time of surgery. We obtained a visual analog scale for pain, the SF-36, and the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. Component stability was assessed using weightbearing radiographs. The minimum followup was 3.1 years (average, 5.3 years; range, 3.1-8.6 years).Results Postoperatively, one patient had débridement of a painful cyst on the tibial side and one patient had a subfibular débridement with a lateral ligament reconstruction. The tibial and talar components were stable in all ankles. The average pain score decreased from 6.7 (range, 3-10) to 1.9 (range, 0-4). All eight categories of SF-36 score showed improvement. The hindfoot score increased from 46 (range, 22-67) to 84 (range, 74-94). Conclusions Our data suggest TAA in patients with ankle osteoarthritis secondary to HH is associated with a low risk of postoperative complications and produces pain relief and good function.

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