Total ankle arthroplasty outcome comparison for post-traumatic and primary osteoarthritis

Mobile-bearing total ankle arthroplasty designs have achieved good clinical results for the treatment of ankle osteoarthritis. However, no direct comparison of the outcomes of total ankle arthroplasty has been made between post-traumatic and primary osteoarthritis. The purpose of the present study was to compare the clinical and radiographic outcomes of total ankle arthroplasty in patients with post-traumatic and primary osteoarthritis.

The HINTEGRA total ankle arthroplasty was carried out in 65 patients (67 ankles) with symptomatic ankle osteoarthritis. Group A included 37 patients (37 ankles) with post-traumatic osteoarthritis, whereas Group B included 28 patients (30 ankles) with primary osteoarthritis. Patients were assessed clinically and radiographically at a mean followup of 38 months.

No significant differences were found between the two study groups in terms of American Orthopaedic Foot and Ankle Society ankle-hindfoot scales, range of motion, or radiographic values at final followup (p > 0.05). The incidence of complications (38% in Group A, 27% in Group B) and additional procedures (54% in Group A, 27% in Group B) was significantly higher in Group A (p = 0.014 for complications, p = 0.013 for additional procedures). One ankle was revised in Group A for a deep infection.

The clinical and radiographic outcomes of total ankle arthroplasty for post-traumatic and primary osteoarthritis were comparable, although the incidence of complications after total ankle arthroplasty was higher in the post-traumatic osteoarthritis group. More preceding or concomitant surgeries were required in order to make the post-traumatic cases suitable for total ankle arthroplasty.