Total Ankle Arthroplasty Survivorship: A Meta-analysis

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Ankle arthrodesis was the traditional standard for end-stage ankle arthritis.
• Total ankle replacement (TAR) is emerging as a viable alternative due to implant advancements.

Purpose of the Study:

• To evaluate the survivorship of currently used total ankle replacement implants through a meta-analysis.

Main Methods:

• A comprehensive literature search identified 10 studies with 1963 implants meeting inclusion criteria.
• A random-effects model was used to analyze overall survivorship.
• Meta-regression explored factors influencing survivorship, including follow-up duration, age, and implant type.

Main Results:

• Overall implant survivorship was 93.0% (95% CI, 85.2-96.9).
• Survivorship showed an inverse relationship with study follow-up duration (p < .0001).
• Higher preoperative functional scores were associated with improved survivorship (p = .001).
• Implant type and patient age did not significantly impact survivorship (p = .213).
• Common complications included technical error, subsidence, and implant failure.

Conclusions:

• Current total ankle replacement implants demonstrate promising survivorship.
• Higher quality studies with standardized outcomes are necessary for definitive conclusions.
• Patient preoperative functional status is a key factor in successful total ankle replacement outcomes.