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Risk factors for total ankle arthroplasty failure: A Dutch Arthroplasty Register study
J P S Hermus1, S M J van Kuijk2, A Spekenbrink-Spooren3
1Department of Orthopaedic Surgery, Research school CAPHRI, Maastricht University Medical Center+, Maastricht, The Netherlands.
Summary
Total ankle arthroplasty (TAA) shows excellent short-term survival rates. However, younger patients, those with higher BMI, or prior OCD treatment face increased revision risk, necessitating careful patient selection for improved TAA outcomes.
Area of Science:
- Orthopedic surgery
- Arthroplasty research
- Biomaterials science
Background:
- Total ankle arthroplasty (TAA) studies may contain bias.
- National arthroplasty registries offer objective survival and outcome data.
- This study analyzes TAA survival and early failure risk factors using Dutch Arthroplasty Register data.
Purpose of the Study:
- To determine the survival rate of total ankle arthroplasties (TAA).
- To identify risk factors associated with early implant failure in TAA.
- To utilize objective data from the Dutch Arthroplasty Register (LROI) for analysis.
Main Methods:
- Retrieved data for 836 TAAs in 810 patients from the LROI (2014-2020).
- Median follow-up was 38 months (range 1-84 months).
- Kaplan-Meier analysis calculated survival; hazard ratios identified failure risk factors (revision or arthrodesis).
Main Results:
- Implant survival was 95.3% at a median follow-up of 38 months.
- Statistically significant risk factors for implant failure included: prior OCD treatment (HR=6.21), BMI (HR=1.09), and younger age (HR=0.71).
- Medial malleolus osteotomy, previous surgery, osteotomy, and ligament reconstruction showed potential clinical associations with failure.
Conclusions:
- TAA demonstrates excellent short-term survival (95.3%) based on LROI data.
- Younger age, higher BMI, and prior surgical OCD treatment are identified risk factors for early TAA revision.
- Optimizing TAA survivorship may depend on careful patient selection to mitigate risks of early implant failure.
