Risk Stratification for Revision Surgery Following Total Ankle Replacement

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Medical device technology

Background:

• Total ankle replacement (TAR) is an increasingly viable surgical option for end-stage ankle arthritis due to implant advancements.
• However, TAR procedures are associated with significant intraoperative and postoperative complication rates.

Purpose of the Study:

• To develop a comprehensive complication classification system for total ankle replacement (TAR) using recent implant data.
• To stratify the risk of subsequent surgeries associated with TAR complications.

Main Methods:

• A systematic review of 16 studies (2013-2018) involving 3,305 total ankle replacements (TAR) was conducted.
• Inclusion criteria focused on current implants, minimum patient numbers, and follow-up duration; revision cases and non-peer-reviewed articles were excluded.

Main Results:

• The overall survival rate for TAR implants was 93%.
• A pooled complication rate of 75.6% was identified using existing classification criteria.
• Existing systems by Gadd et al. and Glazebrook et al. showed limitations in defining and classifying all complications.

Conclusions:

• An updated classification system is proposed to better capture complications associated with current total ankle replacement (TAR) implants.
• This enhanced system aims to provide more accurate complication reporting and risk stratification for improved procedural success.