Survivorship of First-, Second-, and Third-Generation Total Ankle Replacement Systems

Roukis, Thomas S.; Bartel, Annette F.P.

doi:10.1007/978-3-319-24415-0_2

Cited by 3 publications

(3 citation statements)

References 48 publications

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“…However, as the majority of the surgeons had their learning curve before the introduction of the 3rd-generation Hintegra the effect size could likely reflect learning curve bias rather than type II error of the design difference. This is supported by Roukis et al (2016), who pointed out that design may not be so important as previously believed, as much as the weighted mean survival after the 1st-generation TAA prostheses was 0.76 at 10 years, for 2nd generation 0.83 and for 3rd generation 0.83.…”

Section: Discussionsupporting

confidence: 59%

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

et al. 2020

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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.

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Section: Discussionsupporting

confidence: 59%

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

et al. 2020

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“…Although there are multiple comparative trials that address these 2 treatment options, neither the complication risk nor the relative effectiveness is clearly established. 5,21,26,29,30…”

Section: Introductionmentioning

confidence: 99%

“…Although there are multiple comparative trials that address these 2 treatment options, neither the complication risk nor the relative effectiveness is clearly established. 5,21,26,29,30 Adverse events (AEs) in orthopedics may have a negative impact on medical care, increase costs, and reduce the effectiveness of treatment. 28 Rates of AEs in ankle arthritis are not clear.…”

Section: Introductionmentioning

confidence: 99%