Yves Gramlich1, Oliver Neun2, Alexander Klug2, Johannes Buckup2, Thomas Stein2, Arvid Neumann2, Sebastian Fischer2, Hans-Peter Abt2, Reinhard Hoffmann2. 1. Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Germany. yves.gramlich@bgu-frankfurt.de. 2. Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstr. 430, 60389, Frankfurt am Main, Germany.
Abstract
INTRODUCTION: Extremely heterogeneous revision rates in total ankle arthroplasty (TAA) of the upper ankle joint are reported and result to heterogeneous collectives and to short follow-up times. The aim is to investigate revision rates and the underlying reasons, as well as treatment outcome and quality of life after TAA in post-traumatic cases with sufficient follow-up. METHODS: In 2008-2013, 74 patients with post-traumatic arthrosis were treated using TAA with a Tornier Salto prosthesis, and 60 (35 males and 25 females; mean age 56) were followed-up (mean: 59 months; range 24-91 months). RESULTS: The revision rate after TAA was 42% (n = 25), and it was 8% after 12 months and 18% after 24 months. Twenty percent of the patients had significant symptomatic periprosthetic bone cysts, 5% had impingement, 3% had soft tissue infections, and, in 14%, revision was caused by other factors. The most commonly performed procedures were cyst debridement and autologous spongy bone grafting (20%). Fifteen percent (n = 9) of the prosthetics were explanted or switched to a tibiotalar arthrodesis (TTA). The mean AOFAS (American Orthopaedic Foot and Ankle Society) score was 55.15 (range 12-100) and the mean FAO (Foot and Ankle Outcome) score was 49.6 (range 18-100). The revision subgroup had impaired outcomes (AOFAS 38.84; FAO 35.5) while the non-revision subgroup had improved outcomes (AOFAS 66.8; FAO 60.48). TAA patients undergoing conversion to TTA had worse outcomes (AOFAS 39; FAO 35.29). CONCLUSION: Total ankle replacement in post-traumatic end-stage arthrosis patients is associated with high revision rates. High rates of symptomatic periprosthetic bone cysts caused high rates of revision surgery and worse outcomes, which were not improved by secondary TTA.
INTRODUCTION: Extremely heterogeneous revision rates in total ankle arthroplasty (TAA) of the upper ankle joint are reported and result to heterogeneous collectives and to short follow-up times. The aim is to investigate revision rates and the underlying reasons, as well as treatment outcome and quality of life after TAA in post-traumatic cases with sufficient follow-up. METHODS: In 2008-2013, 74 patients with post-traumatic arthrosis were treated using TAA with a Tornier Salto prosthesis, and 60 (35 males and 25 females; mean age 56) were followed-up (mean: 59 months; range 24-91 months). RESULTS: The revision rate after TAA was 42% (n = 25), and it was 8% after 12 months and 18% after 24 months. Twenty percent of the patients had significant symptomatic periprosthetic bone cysts, 5% had impingement, 3% had soft tissue infections, and, in 14%, revision was caused by other factors. The most commonly performed procedures were cyst debridement and autologous spongy bone grafting (20%). Fifteen percent (n = 9) of the prosthetics were explanted or switched to a tibiotalar arthrodesis (TTA). The mean AOFAS (American Orthopaedic Foot and Ankle Society) score was 55.15 (range 12-100) and the mean FAO (Foot and Ankle Outcome) score was 49.6 (range 18-100). The revision subgroup had impaired outcomes (AOFAS 38.84; FAO 35.5) while the non-revision subgroup had improved outcomes (AOFAS 66.8; FAO 60.48). TAA patients undergoing conversion to TTA had worse outcomes (AOFAS 39; FAO 35.29). CONCLUSION: Total ankle replacement in post-traumatic end-stage arthrosispatients is associated with high revision rates. High rates of symptomatic periprosthetic bone cysts caused high rates of revision surgery and worse outcomes, which were not improved by secondary TTA.
Entities:
Keywords:
TAA complications; Tornier Salto; Total ankle arthroplasty
Authors: Fabian G Krause; Markus Windolf; Biraj Bora; Murray J Penner; Kevin J Wing; Alastair S E Younger Journal: J Bone Joint Surg Am Date: 2011-04-15 Impact factor: 5.284
Authors: Charles L Saltzman; Michael L Salamon; G Michael Blanchard; Thomas Huff; Andrea Hayes; Joseph A Buckwalter; Annunziato Amendola Journal: Iowa Orthop J Date: 2005
Authors: Mark Glazebrook; Tim Daniels; Alastair Younger; C J Foote; Murray Penner; Kevin Wing; Johnny Lau; Ross Leighton; Michael Dunbar Journal: J Bone Joint Surg Am Date: 2008-03 Impact factor: 5.284
Authors: C Stadler; M Stöbich; B Ruhs; C Kaufmann; L Pisecky; S Stevoska; T Gotterbarm; M C Klotz Journal: Arch Orthop Trauma Surg Date: 2021-06-04 Impact factor: 3.067
Authors: Fernando J Quevedo González; Brett D Steineman; Daniel R Sturnick; Jonathan T Deland; Constantine A Demetracopoulos; Timothy M Wright Journal: J Orthop Res Date: 2020-10-20 Impact factor: 3.494
Authors: Brett D Steineman; Fernando J Quevedo González; Daniel R Sturnick; Jonathan T Deland; Constantine A Demetracopoulos; Timothy M Wright Journal: J Orthop Res Date: 2020-11-11 Impact factor: 3.494
Authors: Sultan Ayyadah Alanazi; Bill Vicenzino; Christiaan J A van Bergen; David J Hunter; Erik A Wikstrom; Hylton B Menz; Yvonne M Golightly; Michelle D Smith Journal: Trials Date: 2022-09-05 Impact factor: 2.728