Survivorship of 4,748 Contemporary Total Ankle Replacements from the French Discharge Records Database

Dagneaux, Louis; Nogue, Erika; Mathieu, Julie; Demoulin, David; Canovas, François; Molinari, Nicolas

doi:10.2106/jbjs.21.00746

Cited by 11 publications

(6 citation statements)

References 35 publications

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“…Moreover, many studies that reported no statistically significant risk association between patient age with primary TAA failure tended to be limited in the number of patients included [ 31 , 33 , 34 ]. A recent study on a total of 4748 patients, with 677 patients under the age of 50 years, found that younger age is a significant patient risk factor, which is in agreement with the findings of our study [ 26 ].…”

Section: Discussionsupporting

confidence: 93%

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Long-Term Survival Analysis of 5619 Total Ankle Arthroplasty and Patient Risk Factors for Failure

Subramanian,

Kim,

Kim

et al. 2023

JCM

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Background: Total ankle arthroplasty (TAA) has higher complication and failure rates compared to other surgical joint replacement procedures despite technological advances. This study aimed to find the long-term survivability of the TAA procedure and identify the patient risk factors for failure with one of the largest cohorts of patients in the literature. Methods: This retrospective cohort study involving cases between 2007 and 2018 analyzed patients who received an index primary TAA procedure in Korea. A total of 5619 cases were included in the final analysis. The TAA failure was defined as either a case with revision arthroplasty or a case with TAA implant removal and arthrodesis performed after primary TAA. Results: During the study period, the 5-year survival rate was 95.4% (95% CI, 94.7–96.1%), and the 10-year survival rate was 91.1% (95% CI, 89.1–93.1%). A younger age (<55 years, adjusted hazard ratio [AHR], 1.725; 55–64 years, AHR, 1.812; p < 0.001 for both), chronic pulmonary disease (AHR, 1.476; p = 0.013), diabetes (AHR, 1.443; p = 0.014), and alcohol abuse (AHR, 1.524; p = 0.032) showed a significantly high odds ratio for primary TAA failure in Cox regression analysis. Conclusion: The 10-year TAA survivorship rate was 91.1%. A younger age, chronic pulmonary disease, diabetes, and heavy alcohol consumption are risk factors for TAA.

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Section: Discussionsupporting

confidence: 93%

“…They also noted that with the use of modern prostheses, survival analysis showed improved results [ 25 ]. Similarly, another study using the French exhaustive discharge database reported a 5-year survival rate of 84% and a 10-year survival rate of 78% [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival Analysis of 5619 Total Ankle Arthroplasty and Patient Risk Factors for Failure

Subramanian,

Kim,

Kim

et al. 2023

JCM

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“…Long-term and large-scale follow-up of ankle replacement has been further reported, including some of the first available registry data. Using the French Discharge Records Database, Dagneaux et al 39 found survivorship of metal components to be 84% at 5 years and 78% at 10 years. Younger age, second-generation implants, and low institutional volume for the procedure were independent predictors of all-cause revision.…”

Section: Ankle Arthritis and Reconstructionmentioning

confidence: 99%

What’s New in Foot and Ankle Surgery

Hembree

Tarka

Pasternack

et al. 2023

Journal of Bone and Joint Surgery

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“…However, Usuelli et al reported greater improvements in patient-reported outcomes (PROs) following TAA in younger patients 10 . Other studies have shown the exact opposite, with higher rates of revision and implant failure in younger cohorts or with younger age being an independent predictor of all-cause revisions [11][12][13] . To date, no clear consensus regarding the association between age and outcomes after TAA has been established.…”

mentioning

confidence: 96%

Younger Patients Undergoing Total Ankle Arthroplasty Experience Higher Complication Rates and Worse Functional Outcomes

Anastasio,

Kim,

Wixted

et al. 2023

Journal of Bone and Joint Surgery

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Background: Although many patients with posttraumatic ankle arthritis are of a younger age, studies evaluating the impact of age on outcomes of primary total ankle arthroplasty (TAA) have revealed heterogenous results. The purpose of the present study was to determine the effect of age on complication rates and patient-reported outcomes after TAA. Methods: We retrospectively reviewed the records of 1,115 patients who had undergone primary TAA. The patients were divided into 3 age cohorts: <55 years (n = 196), 55 to 70 years (n = 657), and >70 years (n = 262). Demographic characteristics, intraoperative variables, postoperative complications, and patient-reported outcome measures were compared among groups with use of univariable analyses. Competing-risk regression analysis with adjustment for patient and implant characteristics was performed to assess the risk of implant failure by age group. The mean duration of follow-up was 5.6 years. Results: Compared with the patients who were 55 to 70 years of age and >70 years of age, those who were <55 years of age had the highest rates of any reoperation (19.9%, 11.7%, and 6.5% for the <55, 55 to 70, and >70-year age groups, respectively; p < 0.001), implant failure (5.6%, 2.9%, and 1.1% for the <55, 55 to 70, and >70-year age groups, respectively; p = 0.019), and polyethylene exchange (7.7%, 4.3%, and 2.3% for the <55, 55 to 70, and >70-year age groups, respectively; p = 0.021). Competing-risk regression revealed a decreased risk of implant failure for patients who were >70 of age compared with those who were <55 years of age (hazard ratio [HR], 0.21 [95% confidence interval (CI), 0.05 to 0.80]; p = 0.023) and for patients who were 55 to 70 years of age compared with those who were <55 years of age (HR, 0.35 [95% CI, 0.16 to 0.77]; p = 0.009). For all subscales of the Foot and Ankle Outcome Score (FAOS) measure except activities of daily living, patients who were <55 years of age reported the lowest (worst) mean preoperative and postoperative scores compared with those who were 55 to 70 years of age and >70 years of age (p ≤ 0.001). Patients who were <55 years of age had the highest mean numerical pain score at the time of the latest follow-up (23.6, 14.4, 12.9 for the <55, 55 to 70, and >70-year age groups, respectively; p < 0.001). Conclusions: Studies involving large sample sizes with intermediate to long-term follow-up are critical to reveal age-related impacts on outcomes after TAA. In the present study, which we believe to be the largest single-institution series to date evaluating the effect of age on outcomes after TAA, younger patients had higher rates of complications and implant failure and fared worse on patient-reported outcome measures. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Survivorship of 4,748 Contemporary Total Ankle Replacements from the French Discharge Records Database

Cited by 11 publications

References 35 publications

Long-Term Survival Analysis of 5619 Total Ankle Arthroplasty and Patient Risk Factors for Failure

Long-Term Survival Analysis of 5619 Total Ankle Arthroplasty and Patient Risk Factors for Failure

What’s New in Foot and Ankle Surgery

Younger Patients Undergoing Total Ankle Arthroplasty Experience Higher Complication Rates and Worse Functional Outcomes

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