Intermediate-term Results of Mobile-bearing Total Ankle Replacement

Deleu, Paul-André; Bevernage, Bernhard Devos; Gombault, Vincent; Maldague, Pierre; Leemrijse, Thibaut

doi:10.1177/1071100714561058

Cited by 46 publications

(29 citation statements)

References 54 publications

(88 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hanna et al (2007) showed that radiographs are not sufficient to diagnose cyst formation or osteolysis. Deleu et al (2014) indicated 24 cases of osteolysis in 50 patients with the Hintegra prosthesis. This number, larger than ours, can most likely be explained by our limitation in radiographic imaging.…”

Section: Discussionmentioning

confidence: 99%

12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center

et al. 2020

View full text Add to dashboard Cite

Background and purpose — Total ankle arthroplasties (TAAs) have larger revision rates than hip and knee implants. We examined the survival rates of our primary TAAs, and what different factors, including the cause of arthritis, affect the success and/or revision rate. Patients and methods — From 2004 to 2016, 322 primary Hintegra TAAs were implanted: the 2nd generation implant from 2004 until mid-2007 and the 3rd generation from late 2007 to 2016. A Cox proportional hazards model evaluated sex, age, primary diagnosis, and implant generation, pre- and postoperative angles and implant position as risk factors for revision. Results — 60 implants (19%) were revised, the majority (n = 34) due to loosening. The 5-year survival rate (95% CI) was 75% (69–82) and the 10-year survival rate was 68% (60–77). There was a reduced risk of revision, per degree of increased postoperative medial distal tibial angle at 0.84 (0.72–0.98) and preoperative talus angle at 0.95 (0.90–1.00), indicating that varus ankles may have a larger revision rate. Generation of implant, sex, primary diagnosis, and most pre- and postoperative radiological angles did not statistically affect revision risk. Interpretation — Our revision rates are slightly above registry rates and well above those of the developer. Most were revised due to loosening; no difference was demonstrated with the 2 generations of implant used. Learning curve and a low threshold for revision could explain the high revision rate.

show abstract

Section: Discussionmentioning

confidence: 99%

12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Fuchs and colleagues, in their 20-year follow-up study on ankle arthrodesis, found a significant negative impact not only on activities of daily living but also on patients' emotional aspects (7) . Total ankle arthroplasty is expected to improve quality of life, decrease pain, and improve gait (11) . The first TAA was performed by Lord and Marotte in 1970 using an inverted hip prosthesis, with disappointing results (7,9,(11)(12)(13) .…”

Section: Discussionmentioning

confidence: 99%

“…Total ankle arthroplasty is expected to improve quality of life, decrease pain, and improve gait (11) . The first TAA was performed by Lord and Marotte in 1970 using an inverted hip prosthesis, with disappointing results (7,9,(11)(12)(13) . Dedicated first-generation TAA implants had constrained designs; these cemented prosthesis with constrained bearings did not have great medium-to long-term outcomes, with a high failure rate due to loosening (11,(13)(14)(15) .…”

Section: Discussionmentioning

confidence: 99%

“…The HINTEGRA TAA, in particular, was designed to allow for less bone resection and a better surgical technique with a potentially longer survivorship. As is commonly seen in the literature, majority of the published data regarding TAA comes from the designing surgeons, the Hintegra TAA is no different (1,2,(4)(5)(6)11) . These publications often report better survivorship than that reported by general surgeons.…”

Section: Introductionmentioning

confidence: 99%

“…Outcomes from non-designer surgeons also needs to be reported. It is necessary to report the clinical outcome of TAA as a quality measure and not only by revision rates (11) .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Medium-term results of the HINTEGRA total ankle arthroplasty

2020

View full text Add to dashboard Cite

Objective: The aim of this study was to determine patient satisfaction, survivorship, and revision rate of the HINTEGRA total ankle arthroplasty (TAA). Our secondary objective was to assess hindfoot function. Methods: All patients who underwent a HINTEGRA TAA between 2007 and 2014 were evaluated. We included a total of 69 patients (69 ankles), who were subjected to clinical and radiological examination and completed a visual analogue scale (VAS) for pain, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and the self-reported foot and ankle score (SEFAS). Hindfoot function was assessed using the AOFAS hindfoot score. Mean follow-up was 62 (57–101) months. Results: The mean VAS score was 2 (0–3) and the SEFAS was 37 (26–48) at the most recent follow-up, while the AOFAS ankle score improved from 57 (52–62) to 87 (82–93). The AOFAS hindfoot score improved from 82 to 92 postoperatively. Eight patients had periprosthetic osteolysis and 5 underwent bone grafting of cysts. We detected polyethylene and hydroxyapatite particles in specimens obtained from the cysts. Eight patients had their procedures converted to an ankle arthrodesis. Conclusion: In select patients, TAA improved quality of life. Our medium-term follow-up of the HINTEGRA TAA observed a survivorship of 89% at 5 years with an improvement in the AOFAS score and a mean SEFAS score of 37. We recommend that large periprosthetic cysts, which may be caused by the hydroxyapatite coating and polyethylene particles, be bone grafted prophylactically. We found hindfoot function to be preserved. Level of Evidence IV; Therapeutic Studies; Case Series.

show abstract