Long-Term Clinical Outcomes and Implant Survivorship of 151 Total Ankle Arthroplasties Using the HINTEGRA Prosthesis

Abstract

Background: Few studies have investigated long-term clinical outcomes of a mobile-bearing total ankle arthroplasty (TAA) system. This study analyzed long-term outcomes of TAA using the HINTEGRA prosthesis at a single, non-developer center.Methods: Primary TAAs were performed on 213 ankles in 194 patients, and 151 consecutive ankles [71%] in 136 patients with a minimum follow-up of 10 years after the primary TAA were included in this study. Clinical results were assessed using a visual analog scale (VAS) pain score, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Scale score, the Ankle Osteoarthritis Scale (AOS) pain and disability subscores, and ankle range of motion. Prosthesis survivorship, reoperations, and risk factors were also evaluated. Results:The mean follow-up was 135.5 months (range, 120.0 to 204.0 months). All clinical scores and ankle range of motion improved significantly from preoperatively to 2 years, 4 to 6 years, and ‡10 years after TAA (p < 0.001). A total of 43 ankles (28.5%) required revision procedures, with the most common reason being periprosthetic osteolysis (32 ankles [21.2%]). The overall implant survivorship was 93.5% in Kaplan-Meier survival analysis at the mean follow-up of 11.3 years after the TAA.Conclusions: TAA using the HINTEGRA prosthesis with careful follow-up observation and appropriate adjunct procedures for the treatment of end-stage ankle arthritis produced satisfactory clinical results, which were maintained at a follow-up of ‡10 years, and resulted in 93.5% of implant survivorship.

Early Outcomes of Combined Total Ankle Total Talus Replacement Using a 3D-Printed Talus Component With Hindfoot Arthrodesis

“…Similar to the pain score improvement in this study, multiple TAR studies showed significant postoperative improvement in VAS. 25,26 In terms of range of motion after TAR, Nunley et al 25 showed significant improvements of ankle dorsiflexion (2.9° vs 6.3°) and plantarflexion (22.2° vs 26.9°) in 82 patients who underwent a Scandinavian Total Ankle Replacement (STAR) at an average 61 months follow-up. With respect to ankle motion after an isolated TTR, Taniguchi et al 11 reported on 55 ceramic TTR.…”

What’s New in Foot and Ankle Surgery

“…Yoon et al 12 retrospectively analyzed long-term outcomes of 151 TAAs (136 patients) using the mobile-bearing HINTEGRA prosthesis (Newdeal/Integra). At a minimum follow-up of 10 years, significant improvement was seen in clinical outcome measures and ankle range of motion (p < 0.001).…”

The Role of Receptor Activator of Nuclear Factor-κB Ligand/Osteoprotegerin Ratio in Synovial Fluid as a Potential Marker for Periprosthetic Osteolysis Following Total Ankle Arthroplasty

“… 1 2 3 4 5 6) However, with complication rates as high as 30%, periprosthetic osteolysis emerges as a significant factor affecting prosthesis longevity. 1 5 7 8) The prevention, diagnosis, and management of osteolysis continue to pose considerable challenges. 9 10) …”