Long-Term Follow-Up of Mobile Bearing Total Ankle Arthroplasty in the United States

Jastifer, James R.; Coughlin, Michael J.

doi:10.1177/1071100714550654

Cited by 84 publications

(65 citation statements)

References 28 publications

(33 reference statements)

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“…The third generation of implants was less constrained, two- or three-component design. Although these implants offer majors advantages over the past designs which commonly failed due to loosening and osteolysis, the clinical outcomes are still less satisfactory than total hip and total knee arthroplasty [ 14 ]. A randomized prospective study conducted on 200 ankle replacements of the three-component Buechel-Pappas (BP) and the Scandinavian Total Ankle Replacement (STAR), found a six year survivor-ship of 86.5% [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Contact stresses, pressure and area in a fixed-bearing total ankle replacement: a finite element analysis

Martinelli

Baretta

Pagano

et al. 2017

BMC Musculoskelet Disord

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BackgroundMobile-bearing ankle implants with good clinical results continued to increase the popularity of total ankle arthroplasty to address endstage ankle osteoarthritis preserving joint movement. Alternative solutions used fixed-bearing designs, which increase stability and reduce the risk of bearing dislocation, but with a theoretical increase of contact stresses leading to a higher polyethylene wear. The purpose of this study was to investigate the contact stresses, pressure and area in the polyethylene component of a new total ankle replacement with a fixed-bearing design, using 3D finite element analysis.MethodsA three-dimensional finite element model of the Zimmer Trabecular Metal Total Ankle was developed and assembled based on computed tomography images. Three different sizes of the polyethylene insert were modeled, and a finite element analysis was conducted to investigate the contact pressure, the von Mises stresses and the contact area of the polyethylene component during the stance phase of the gait cycle.ResultsThe peak value of pressure was found in the anterior region of the articulating surface, where it reached 19.8 MPa at 40% of the gait cycle. The average contact pressure during the stance phase was 6.9 MPa. The maximum von Mises stress of 14.1 MPa was reached at 40% of the gait cycle in the anterior section. In the central section, the maximum von Mises stress of 10.8 MPa was reached at 37% of the gait cycle, whereas in the posterior section the maximum stress of 5.4 MPa was reached at the end of the stance phase.DiscussionThe new fixed-bearing total ankle replacement showed a safe mechanical behavior and many clinical advantages. However, advanced models to quantitatively estimate the wear are need.ConclusionTo the light of the clinical advantages, we conclude that the presented prosthesis is a good alternative to the other products present in the market.

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Section: Introductionmentioning

confidence: 99%

Contact stresses, pressure and area in a fixed-bearing total ankle replacement: a finite element analysis

Martinelli

Baretta

Pagano

et al. 2017

BMC Musculoskelet Disord

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“…The STARTM ankle was first approved by the US FDA in 1998 [17]. It was a three-part, mobilebearing, uncemented ankle replacement.…”

Section: Star Ankle Prosthesismentioning

confidence: 99%

“…However, the rate of additional procedures was also high, which highlights the need for patient follow-up and additional long-term outcome studies on TAR [17].…”

Section: Outcomes Of Tarmentioning

confidence: 99%

“…In the current cohort of STAR patients, implant survival at a minimum of 10 years of follow-up was high. However, 39% of patients required some sort of secondary procedure, most of which occurred after 9 years of follow-up [17]. A. Henricson et al defined ankle replacement revision as the extraction of one or more bone-incorporated components or the exchange of a broken plastic component without any known trauma' [49,50].…”

Section: Revision Of Tarmentioning

confidence: 99%

“…Risk factors associated with prolonged hospital stay were advanced age, female sex, diabetes mellitus, and more than one general or surgery-related complication [63]. The published literature on the long-term followup of modern TAR achieved significantly higher implant survival rates, patient satisfaction, pain relief, and range of motion (ROM) and American Orthopaedic Foot and Ankle Society (AOFAS) scores following the third ankle prosthesis [29,64]. Complication and survivorship rates were comparable between both groups [65].…”

Section: Decision-making Process Of Using Arthrodesis or Tarmentioning

confidence: 99%

See 2 more Smart Citations

The Current Trend of Total Ankle Replacement

Zhou¹,

Tang²

2016

Arthroplasty - A Comprehensive Review

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Total ankle replacement (TAR) was introduced for end-stage arthritis of the ankle joint in the 1970s. TAR is becoming the modality of choice and offers better mobility, improved gait, and reduces the development of subsequent subtalar joint arthritis when compared with ankle arthrodesis. To maintain the longest function of ankle replacements, the design of the prosthesis should allow for smooth and continuous interaction and normal gait. Improved operative techniques, the surgeon's experience, as well as appropriate patient selection can anticipate better outcomes. Deformities of the ankle and foot should be corrected before TAR is performed. Despite the functional limitations following the revision of TAR, the revision still offers a cost-effective alternative to ankle arthrodesis. The decision to treat with TAR depends on the surgeon's technique, as well as on the patient's condition.

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