Mid-Term Prospective Clinical and Radiographic Outcomes of a Modern Fixed-Bearing Total Ankle Arthroplasty

The early outcomes of the Salto Talaris® Total Ankle Prosthesis have been promising, but information on its mid-term outcomes is still sparse. The purpose of this study was to evaluate the mid-term clinical and radiographic outcomes of this implant among a prospective cohort of patients who underwent total ankle replacement for various etiologies. Forty-six patients (50 ankles) were consecutively enrolled in the study. Our primary aim was to assess implant survivorship as determined by the removal or revision of the implant metal components or conversion to arthrodesis. Our secondary aim was to gauge patient outcomes by using commonly used outcome scores and assess ankle range of motion using goniometric and radiographic methods. We report 100% survivorship of the implant at a mean follow-up of 4.9 years. Compared with preoperative levels, all clinical outcome scores showed significant improvement at the 1-year, 2-year, and 5-year and longer follow-up. The mean clinical ROM improved from 27.7° ± 10.7° preoperatively to 40.0° ± 12.3° at the 2-year follow-up (p < .001). The mean radiographic ROM improved from 23.0° ± 10.2° preoperatively to 27.2° ± 9.1° at the 2-year follow-up (p = .007). Reoperations or secondary procedures were performed on 6 (12%) ankles, with the most common procedure being gutter debridement for impingement symptoms. The study confirms that the excellent survivorship seen with the implant in the early studies extends to mid-term follow-up as well. Patients could expect to see improvement in pain relief and activity well into 5 years after surgery and retain sufficient ankle range of motion for normal gait.