Age-Related Outcomes in Total Ankle Arthroplasty: An Analysis of 112 Patients

Traditionally, total ankle replacement has been reserved for elderly patients with low physical demands. With nearly 80% of end-stage ankle arthritis being secondary to prior trauma, patients may require a replacement at a much younger rate than primary hip and knee arthritis. Historical accounts of implant failure and high revision rates in younger patients have been reported in the literature. With increasing technology and surgeon experience, implants are being used in younger patients with significantly fewer complications than early reports. In this retrospective review, we evaluated the patient-reported outcome measures and implant complications in three age subsets in arthroplasty patients; Group 1: <55 years-old, Group 2: 55-70 years-old, and Group 3: >70 years-old. In our study, mean postoperative American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scores were 75.5 for group 1, 79.7 for group 2, and 86.9 for group 3, which improved from preoperative scores of 50, 52.4, and 53.8, respectively. Mean postoperative Foot Function Index (FFI) scores were 10 for group 1, 23.9 for group 2, and 12.3 for group 3, which improved from 59.4, 62.8, and 47.6 preoperatively, respectively. The overall complication rate was found to be 11.2%. The complication rate for group 1 was 18%, the complication rate for group 2 was 11.6%, and the complication rate was 9.4% for group 3. The differences in patient AOFAS hindfoot, FFI scores, and complication rates between the groups were not found to be statistically significant. Our results show that patients younger than age 55 years have similar complication rates and reported satisfaction scores to patients 55 years of age and older.