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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
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Poor prosthesis survival and function after component exchange of total ankle prostheses
Ilka Kamrad1, Anders Henricsson, Magnus K Karlsson
1Departments of Orthopedics and Clinical Sciences , Lund University and Skåne University Hospital , Malmö ;
Acta Orthopaedica
|February 13, 2015
Summary
Revision total ankle replacement (TAR) shows a 10-year survival of 55%, lower than primary TAR. Patient satisfaction with revision TAR is only around 50%, indicating a need for further research on optimal treatment strategies.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- Failed total ankle replacements (TARs) often lead to fusion, but outcomes of component exchange (revision TAR) are debated.
- Assessing revision TAR efficacy is crucial for guiding treatment decisions in failed ankle arthroplasty.
Purpose of the Study:
- To analyze prosthetic survival, self-reported function, and patient satisfaction following revision total ankle replacement.
- To compare the outcomes of revision TAR with those of primary TAR.
Main Methods:
- A cohort of 69 patients undergoing revision TAR between 1993-2013 was identified from the Swedish Ankle Registry.
- Prosthetic survival was estimated using Kaplan-Meier analysis, and patient-reported outcome measures (PROMs) including SEFAS, EQ-5D, EQ-VAS, and SF-36 were evaluated.
Main Results:
- The 10-year survival rate for revision TAR was 55%, significantly lower than the 74% for primary TAR.
- Among patients with revision TAR in situ, mean SEFAS was 22, SF-36 physical score was 37, and EQ-5D index was 0.6.
- Only 15 out of 29 evaluated patients reported satisfaction with their revision TAR, with 9 expressing dissatisfaction.
Conclusions:
- Revision TAR demonstrates a lower long-term survival rate compared to primary TAR.
- Patient satisfaction after revision TAR is suboptimal, with only about half of the patients satisfied.
- Further research is needed to identify patient subgroups that may benefit from revision TAR versus direct ankle fusion.
