[The HINTEGRA ankle: short- and mid-term results]

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Medical Device Design

Background:

• Traditional total ankle replacements often involve significant bone resection and can lead to high contact stresses.
• The HINTEGRA ankle prosthesis was designed to minimize bone resection, provide extensive bone support, ensure ligament balance, and reduce stress on surrounding tissues.
• Evaluating the clinical and radiological performance of novel prostheses is crucial for advancing orthopedic treatments.

Purpose of the Study:

• To present the design and rationale behind the HINTEGRA ankle prosthesis.
• To analyze the short- to mid-term clinical and radiological outcomes of the HINTEGRA ankle.
• To specifically assess revision rates and the learning curve associated with this implant.

Main Methods:

• A retrospective analysis of 271 HINTEGRA ankle replacements performed between 2000 and 2004.
• Clinical and radiographic assessments were conducted on 271 ankles after an average follow-up of 36.1 months.
• Preoperative diagnoses included post-traumatic osteoarthrosis (76.0%), systemic arthritis (12.5%), and primary osteoarthrosis (11.5%).

Main Results:

• The American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score improved significantly from a mean of 40.3 to 85.0.
• A total of 14.4% of cases required revision, with 1.8% revised to ankle arthrodesis; other revisions were successful.
• Radiographically, tibial components remained stable, though 4.4% of talar components were noted to be posteriorly positioned.

Conclusions:

• The HINTEGRA ankle's design principles of minimal bone resection and wide bony support are clinically successful.
• The learning curve for surgeons using the HINTEGRA ankle is short and steep, with most complications occurring early.
• The prosthesis offers promising functional improvement, pain relief, and patient satisfaction, potentially superior to other devices, especially in complex post-traumatic cases.