High revision and reoperation rates using the Agility™ Total Ankle System

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Rehabilitative medicine

Background:

• Total ankle arthroplasty (TAA) is an emerging surgical option for end-stage ankle arthritis.
• Concerns exist regarding the long-term durability and success rates of TAA.

Purpose of the Study:

• To evaluate the implant survival rate of the Agility™ Total Ankle Arthroplasty (TAA).
• To determine the overall reoperation rate in patients who underwent TAA.
• To assess functional outcomes in patients who retained their TAA implants.

Main Methods:

• Retrospective review of 65 Agility™ TAAs in 64 patients (1999-2001).
• Data collected via chart review, questionnaires, and interviews.
• Follow-up ranged from 0.5 to 11 years (median 8 years), with survival defined by revision surgery.

Main Results:

• 39% of TAAs (16/41) required revision surgery, with 38% of revisions occurring within the first year.
• The overall reoperation rate was 68% (28/41) at an average of 8 years.
• Patients retaining implants reported moderate pain relief (VAS 4) and functional scores (FAAM ADL 57, FAAM Sports 33).

Conclusions:

• Total ankle arthroplasty demonstrated high rates of revision and reoperation.
• Implant survival and functional outcomes in patients retaining their implants were only moderate.
• TAA should be approached with caution, and further research into contemporary TAA is warranted.