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Ankle Joint

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

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Early Experience With the CADENCE Total Ankle Prosthesis.

Calvin J Rushing¹, Rona Law², Christopher F Hyer¹

¹Fellowship-Trained Foot and Ankle Surgeon, Orthopedic Foot and Ankle Center, Worthington, OH.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons

|November 1, 2020

Summary

This study reports early outcomes of the CADENCE total ankle prosthesis, showing improved alignment and 94% survivorship at two years. Intraoperative medial malleolar fracture was the most common complication.

Keywords:

complications early revision fixed bearing medial malleolar fracture peri-implant lucency total ankle arthroplasty total ankle replacement

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Area of Science:

Orthopedic Surgery
Biomedical Engineering
Arthroplasty Research

Background:

Fourth-generation, 2-component total ankle arthroplasty prostheses are emerging.
Early clinical experience with novel prostheses requires thorough evaluation.

Purpose of the Study:

To present the initial outcomes and surgical experience with the CADENCE total ankle prosthesis.
To assess the early performance, complications, and survivorship of the CADENCE implant.

Main Methods:

Retrospective review of 32 primary total ankle arthroplasties using the CADENCE prosthesis (August 2016 - June 2018).
Weight-bearing radiographs analyzed for coronal and sagittal tibiotalar alignment preoperatively and postoperatively.
Complications and revisions classified using established criteria (Vander Griend et al., Glazebrook et al.).

Main Results:

Significant improvement in coronal and sagittal tibiotalar alignment post-surgery, maintained at follow-up (p < .001, p < .005).
Early revision for aseptic loosening in 6.3% of cases; 18.8% required non-revisional reoperation.
28.1% of ankles experienced complications, most commonly intraoperative medial malleolar fracture (15.6%).

Conclusions:

The CADENCE total ankle prosthesis demonstrates favorable early outcomes with good alignment and 94% survivorship at 2 years.
Surgeons should be aware of the learning curve associated with this new prosthesis.
Intraoperative medial malleolar fracture is a notable complication requiring attention.