Heterotopic ossification after primary total ankle arthroplasty.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Heterotopic ossification (HO) is a known complication following lower-limb joint arthroplasty.
• No prior comprehensive studies have specifically investigated HO after total ankle arthroplasty (TAA).

Purpose of the Study:

• To determine the prevalence and location of HO after primary TAA.
• To identify predisposing factors for HO development.
• To assess the impact of HO on clinical outcomes and establish a classification system.

Main Methods:

• Prospective follow-up of 80 patients (80 ankles) undergoing primary TAA.
• Mean follow-up duration of 31.9 months.
• Analysis of HO prevalence, location, predisposing factors, clinical outcomes, and development of a classification system.

Main Results:

• Twenty percent (25%) of ankles developed postoperative HO, predominantly in the posterior aspect.
• HO was classified into four grades (I-IV).
• Symptomatic HO occurred in 10% of patients, with two requiring surgical resection.
• Ankles with HO showed longer operative times, reduced motion, and lower AOFAS scores at follow-up.

Conclusions:

• HO is a considerable complication after primary TAA, affecting 25% of patients.
• HO is associated with decreased ankle motion and poorer clinical outcomes at two years.
• Strategies to minimize HO occurrence are crucial in TAA procedures.