[Eleven-Year Experience with Total Ankle Arthroplasty].

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Total ankle arthroplasty (TAA) is a surgical option for advanced ankle arthritis, offering mobility but with lower longevity than hip or knee replacements.
• Treatment decisions for TAA are highly individualized, based on patient's clinical status and preferences.
• Keywords: total ankle arthroplasty, re-implantation, aseptic loosening, retrograde nail, Trabecular Metal spacer, revision arthroplasty.

Purpose of the Study:

• To evaluate the outcomes of total ankle arthroplasty (TAA) in a cohort of patients.
• To analyze the influence of arthritis type and prosthesis used on TAA outcomes.
• To identify common post-operative complications and factors affecting TAA success.

Main Methods:

• A retrospective review of 132 total ankle replacements performed between 2004 and 2015.
• Utilized various prostheses including Ankle Evolutive System (AES), Mobility Total Ankle System, and Rebalance Total Ankle Replacement.
• Assessed outcomes using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale.

Main Results:

• The average AOFAS score significantly improved from 33.2 pre-surgery to 82.5 post-surgery.
• Outcomes were poorer in post-traumatic arthritis (average AOFAS 78.6) compared to rheumatoid or primary arthritis (average AOFAS 86.4).
• Complications occurred in 7.6% of patients, including wound healing issues, ossification, and late infections; 5.3% required prosthesis removal and ankle fusion.

Conclusions:

• Total ankle arthroplasty provides pain relief and improved gait but has lower survivorship than other major joint replacements.
• Correct patient indication is crucial for successful TAA, requiring stable ankles with minimal deformity and no talar necrosis.
• Surgeon experience and prosthesis selection may influence complication rates and long-term outcomes.