Outcomes and Complications of the INFINITY Total Ankle: A Systematic Review

Abstract

Ankle arthroplasty is a viable treatment option for end-stage ankle arthritis and has shown improvements in pain relief, motion, as well as function and gait. Newer generation total ankle prostheses have improved instrumentation and surgical techniques, as well as minimal bone resection on both the tibia and talus. The purpose of this systematic review was to determine the short-term clinical success of the INFINITY total ankle, including the common complications and rate of revision with this prosthesis. We performed a systematic review of electronic databases that included reported complications and revisions using this prosthesis. Complications were recorded according to the Glazebrook classification. Six total published studies with clinical outcomes and complications and 432 prostheses were included. The weighted mean follow-up was 24.5 months and weighted mean patient age was 62.3 years. There were 43 (10.0%) total complications—9 low grade, 16 medium grade, and 18 high grade. There were 26 total revision procedures (6.0%). Revisions were mostly performed for deep infection, aseptic loosening, and subsidence. When including deep infections, the overall implant survivorship was 94%. When excluding the 8 deep infections requiring revision, implant survivorship was 96%. The INFINITY has acceptable short-term complication and revision rates. This fourth-generation prosthesis compares to prior reported studies with earlier generation ankle implants in the short term. Level of Evidence: IV

Two-Year Survivorship and Patient-Reported Outcomes of a Prospectively Enrolled Cohort of INFINITY Total Ankle Arthroplasties

“…In total, 143 patients (148 ankles) were recruited between October 2017 and June 2020 at 9 centers (range of cases per site [6][7][8][9][10][11][12][13][14][15][16][17][18]. A total of 116 completed 2-year follow-up.…”

“…It is a fixed-bearing implant that has approved options for talar interchangeability with flat-topped (INBONE, Stryker, Kalamazoo, MI) domes as needed and uses extramedullary alignment guides but also has the capacity for computed tomography (CT)–derived patient-specific cutting guides. 6,13,24…”

“…It is a fixed-bearing implant that has approved options for talar interchangeability with flattopped (INBONE, Stryker, Kalamazoo, MI) domes as needed and uses extramedullary alignment guides but also has the capacity for computed tomography (CT)-derived patient-specific cutting guides. 6,13,24 The purpose of this study is to report 2-year survivorship, complications, PROMs, and radiologic analysis of 143 patients (148 ankles) who underwent TAA with a fixedbearing implant. The role of patient-specific instrumentation (PSI), degree of preoperative deformity, the Canadian Orthopaedic Foot and Ankle Society (COFAS) grading system, and etiology of arthritis on TAA outcomes is secondarily assessed.…”

Revision Total Ankle Arthroplasty Using the INBONE II System

“…The incidence of total ankle arthroplasty (TAA) as a surgical treatment for end-stage ankle osteoarthritis (OA) is increasing because of improved clinical outcomes from modern design features in TAA. 1,3,6,8,9,20,28 A recent survey of the National Inpatient Sample database in the United States reported that a total of 5315 TAAs were performed in 2017, a more than 5-fold increase in incidence compared with 2005. 31 The increase in utilization of TAA has been driven by factors such as an aging population, an increased prevalence of arthritis, and advancements in implant technology.…”

Ankle Osteoarthritis

“…design TAA. 5,6 Thus, the purpose of this review was to provide an updated overview of ankle OA, including pathophysiologic and diagnostic considerations. We will also address developments in the nonsurgical and surgical treatment of the condition.…”