Ten-year revision rates of contemporary total ankle arthroplasties equal 22%. A meta-analysis

Plaat, Laurens W. van der; Hoornenborg, Daniël; Sierevelt, Inger N.; Dijk, C. Niek van; Haverkamp, Daniël

doi:10.1016/j.fas.2021.05.014

Cited by 3 publications

(4 citation statements)

References 69 publications

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“…The present long-term survival of TAR is estimated at 78% to 84%, 37,39 with a mean calculated revision rate of 18% after 10 years. 16 Combining our lower survival rate with the substantial percentage of complications, our results endorse the abandonment of the CCI.…”

Section: Discussionmentioning

confidence: 99%

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Long-term Follow-up of 254 Ceramic Coated Implant (CCI) Evolution Total Ankle Replacements

Plaat²,

Sierevelt

et al. 2022

Foot Ankle Int.

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Background: The ceramic coated implant (CCI) Evolution was a third-generation implant design used in approximately 2000 total ankle replacements (TARs) between 2003 and 2016. Because this implant was abandoned, long-term follow-up studies are lacking. Methods: All patients undergoing TAR using a CCI prosthesis between 2004 and 2012 were included for analysis. Preoperatively the tibiotalar alignment was measured, and postoperatively the patients were followed up clinically, with radiographs and by questionnaire. The primary outcome was implant survival at 10 years of follow-up. Implant survival was also compared for (1) inflammatory joint disease vs noninflammatory joint disease and (2) preoperative tibiotalar neutral vs varus or valgus alignment. The secondary outcomes were complications, reoperations, and function (assessed by patient-reported outcome measures). Results: Two hundred fifty-four TARs were performed in 237 patients. Two hundred twelve additional procedures were performed to achieve stable ankles. At 10-year follow-up, the survival was 67.5%, with an average time to revision of 4.5 years. The 10-year survival of the inflammatory joint disease group was 76.8% and of the noninflammatory joint group 63.1% ( P = .44). In 248 TARs, the preoperative tibiotalar alignment was measured; (62% neutral, 25% varus, and 13% valgus), these showed 10-year survival rates of 74.7%, 48.2%, and 68.9% respectively ( P = .07). The complication rate was 54%; 37% of patients underwent reoperation. At a mean of 8.5 years, postoperative satisfaction scored an average of 7.0 (SD 2.26) on a 0- to 10-point numeric rating scale. The mean Foot and Ankle Ability Measure sports subscore was 24.7, the mean Foot and Ankle Outcome Score (FAOS) sports subscore was 42.8, and the mean 36-Item Short Form Health Survey score was 40.0. Regarding daily activities, the mean FAOS was 81.0. Conclusion: This is currently the sole study reporting the long-term results of the CCI prosthesis. The survival and functional outcomes were inferior to other third-generation mobile-bearing ankle implants.

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Section: Discussionmentioning

confidence: 99%

“…Patient demographics, surgical, and clinical information was collected after obtaining written informed consent. 20,39 Approval was obtained by our local institutional review board.…”

Section: Methodsmentioning

confidence: 99%

Long-term Follow-up of 254 Ceramic Coated Implant (CCI) Evolution Total Ankle Replacements

Plaat²,

Sierevelt

et al. 2022

Foot Ankle Int.

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“…Revision TAA is expected to become increasingly common given the rising rate of TAAs being performed. 6,9 Previously, failed TAAs were treated with salvage fusion, which has poor clinical and functional outcomes. 4,5 As revision TAA becomes more widely used, there is a heightened need to understand the clinical and radiographic outcomes of such procedures.…”

Section: Discussionmentioning

confidence: 99%

“…5 This increase in TAAs is resulting in a greater need for revision of failed TAA. 9,10 This creates a need for TAA implants available for use in complex revision settings. The Wright INVISION TAA is a novel system with modular augmented components suited to revision scenarios with limited bone stock.…”

Section: Introductionmentioning

confidence: 99%

Early Survivorship, Clinical and Radiographic Outcomes of a Modular Augmented Revision Total Ankle Arthroplasty System

Purnell,

Shaffrey,

Ellis

et al. 2023

Foot Ankle Int.

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Background: As the number of total ankle arthroplasties (TAAs) performed annually increases, there is increased demand for modular revision implants. There is limited early survivorship and clinical outcome data for the INVISION Total Ankle Arthroplasty System (Wright Medical Technology/Stryker). This study aims to determine early implant survivorship, complications, and radiographic and patient-reported outcomes (PROs) of the INVISION implant in the revision setting. Methods: This is a single-institution retrospective review of adult patients who underwent revision TAA with the INVISION implant with minimum 2-year follow-up. Demographics, complications, radiographic data, and PROs (PROMIS) were collected. The primary outcome was implant survivorship. Secondary outcomes were reoperation, radiographic complications, and PROs. Results: Nineteen patients underwent revision INVISION TAA with mean follow-up of 3.5 years. INVISION revision TAA was used for tibial (n = 6) or talar (n = 7) component subsidence, recurrent tibiotalar malalignment (valgus = 1, varus = 3), and postinfection bone loss (n = 2). Two-year implant survivorship was 100%. There were no reoperations. One patient had lucency of the talar component at 6 months post TAA revision with INVISION. One patient had talar subsidence at final follow-up. Two-year postoperative follow-up PROMIS domains improved significantly ( P < .05). Conclusion: There was excellent short-term survivorship of the INVISION TAA implant, with no failures. There were significant improvements in PROs and low rates of subsidence and lucencies. The results of this study support using the INVISION implant in the revision TAA setting. Level of Evidence: Level III, retrospective cohort.

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Hybrid-Total Ankle Arthroplasty (H-TAA) for Failed Talar Component in Mobile-Bearing Total Ankle Arthroplasty

Santini

Alharbi

Teoh

et al. 2023

JCM

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Introduction: Revision Total Ankle Arthroplasty (TAA) surgery due to TAA aseptic loosening is increasing. It is possible to exchange the talar component and inlay to another system for isolated talar component loosening in a primary mobile-bearing TAA: Hybrid-Total Ankle Arthroplasty (H-TAA). The purpose of this study was to analyze the results of the revision surgery of an isolated aseptic talar component loosening in a mobile-bearing three-component TAA with a H-TAA solution. Methods: In this prospective case study, nine patients (six women, three men; mean age 59.8 years; range 41–80 years) with symptomatic isolated aseptic loosening of the talar component of a mobile-bearing TAA were treated with an isolated talar component and inlay substitution. In all nine cases, a hybrid TAA revision surgery was performed by implanting a VANTAGE TAA talar and insert component (Flatcut talar component: six cases, standard talar component: three cases). The patients were reviewed with the pain score (VAS Pain Score 0–10), Dorsiflexion/Plantarflexion (DF/PF) Range of Motion (ROM; degrees), the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle/Hindfoot Score (0–100 points), Sports Frequency Score (Level 0–4), and subjective Patients’ Satisfaction Score (0–10 points). Results: The average Pain score improved significantly from preoperative 6.7 points to postoperative 1.1 points (p < 0.001). Average Dorsiflexion/Plantarflexion ROM values increased significantly post-surgery: 21.7° preoperative to 45.6° postoperative (p < 0.001). The postoperative AOFAS scores were significantly greater than the preoperative values: 47.7 points preoperative, 92.3 points postoperative (p < 0.001). The sports activity improved from preoperative to postoperative where, preoperative, none of the patients were able to perform sports. Postoperative, eight patients were able to be sports-active again. The overall average postoperative level of sports activity was 1.4. The postoperative average patient’s satisfaction was 9.3 points. Conclusion: In painful talar component aseptic loosening of a three-component mobile-bearing TAA, H-TAA is a good surgical solution for reducing pain, restoring ankle function, and improving patients’ life quality.

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Ten-year revision rates of contemporary total ankle arthroplasties equal 22%. A meta-analysis

Cited by 3 publications

References 69 publications

Long-term Follow-up of 254 Ceramic Coated Implant (CCI) Evolution Total Ankle Replacements

Long-term Follow-up of 254 Ceramic Coated Implant (CCI) Evolution Total Ankle Replacements

Early Survivorship, Clinical and Radiographic Outcomes of a Modular Augmented Revision Total Ankle Arthroplasty System

Hybrid-Total Ankle Arthroplasty (H-TAA) for Failed Talar Component in Mobile-Bearing Total Ankle Arthroplasty

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