Christopher Gross1, Brandon J Erickson2, Samuel B Adams2, Selene G Parekh2. 1. Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (CG, SBA, SGP)Rush University Medical Center; Chicago, Illinois (BJE)Duke Fuqua School of Business, Durham, North Carolina (SGP) cgross144@gmail.com. 2. Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina (CG, SBA, SGP)Rush University Medical Center; Chicago, Illinois (BJE)Duke Fuqua School of Business, Durham, North Carolina (SGP).
Abstract
PURPOSE: As the number of total ankle replacements (TARs) performed has risen, so has the need for revision. The purpose of this investigation was to perform a systematic review of clinical outcomes following a salvage ankle arthrodesis from a failed TAR to identify patient- and technique-specific prognostic factors and to determine the clinical outcomes and complications following an ankle arthrodesis for a failed TAR. METHODS: We searched PubMed, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for studies that analyzed ankle fusion after failed TAR with a minimum follow-up of 1 year. RESULTS: We included 16 studies (193 patients). The majority of patients (41%) underwent the index TAR for rheumatoid arthritis. The majority of these revision surgeries were secondary to component loosening, frequently of the talar component (38%). In the cases that were revised to an ankle arthrodesis, 81% fused after their first arthrodesis procedure. The intercalary bone graft group and the blade plate group had the highest rate of fusion after the first attempt at fusion at 100%, whereas the tibiotalocalcaneal fusion with cage group had the lowest fusion rate at 50%. The overall complication rate was 18.2%, whereas the overall nonunion rate was 10.6%. CONCLUSION: A salvage ankle arthrodesis for a failed TAR results in favorable clinical end points and overall satisfaction at short-term follow-up if the patients achieve fusion. The bone graft fusion and blade plate group resulted in the highest first-attempt fusion rate, with a low complication rate. Future studies should include prospective, comparative control or surgical groups and use standardized outcome measurements that will make direct comparisons easier. LEVELS: Level IV: Systematic Review of Level IV Studies.
PURPOSE: As the number of total ankle replacements (TARs) performed has risen, so has the need for revision. The purpose of this investigation was to perform a systematic review of clinical outcomes following a salvage ankle arthrodesis from a failed TAR to identify patient- and technique-specific prognostic factors and to determine the clinical outcomes and complications following an ankle arthrodesis for a failed TAR. METHODS: We searched PubMed, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials for studies that analyzed ankle fusion after failed TAR with a minimum follow-up of 1 year. RESULTS: We included 16 studies (193 patients). The majority of patients (41%) underwent the index TAR for rheumatoid arthritis. The majority of these revision surgeries were secondary to component loosening, frequently of the talar component (38%). In the cases that were revised to an ankle arthrodesis, 81% fused after their first arthrodesis procedure. The intercalary bone graft group and the blade plate group had the highest rate of fusion after the first attempt at fusion at 100%, whereas the tibiotalocalcaneal fusion with cage group had the lowest fusion rate at 50%. The overall complication rate was 18.2%, whereas the overall nonunion rate was 10.6%. CONCLUSION: A salvage ankle arthrodesis for a failed TAR results in favorable clinical end points and overall satisfaction at short-term follow-up if the patients achieve fusion. The bone graft fusion and blade plate group resulted in the highest first-attempt fusion rate, with a low complication rate. Future studies should include prospective, comparative control or surgical groups and use standardized outcome measurements that will make direct comparisons easier. LEVELS: Level IV: Systematic Review of Level IV Studies.
Authors: Cort D Lawton; Bennet A Butler; Robert G Dekker; Adam Prescott; Anish R Kadakia Journal: J Orthop Surg Res Date: 2017-05-18 Impact factor: 2.359
Authors: Federico Morelli; Giorgio Princi; Matteo Romano Cantagalli; Marco Rossini; Ludovico Caperna; Daniele Mazza; Andrea Ferretti Journal: World J Orthop Date: 2021-12-18