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Related Concept Videos

Ankle Joint01:10

Ankle Joint

1.6K
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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Fusion after a failed primary total ankle arthroplasty.

Toby Jennison1,2, Obioha C Ukoumunne3, Sallie Lamb3

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Salvage ankle fusion after total ankle arthroplasty (TAA) failure has moderate reoperation and failure rates, with nearly 25% of patients needing revision within three years. This study analyzes fusion survival following failed TAA using registry data.

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Reconstructive surgery

Background:

  • Total ankle arthroplasty (TAA) is increasingly performed, but failure necessitates salvage procedures like fusion or revision arthroplasty.
  • Limited literature exists on the outcomes of ankle fusion following TAA failure.
  • Understanding the survival of salvage fusions is crucial for patient management.

Purpose of the Study:

  • To analyze the survival rates of ankle fusions performed as a salvage procedure after TAA failure.
  • To utilize a large dataset from the National Joint Registry (NJR) for robust analysis.

Main Methods:

  • A data linkage study combined NJR and NHS Digital data.
  • TAA failure was defined by subsequent fusion, revision arthroplasty, or amputation.
  • Life tables, Kaplan-Meier graphs, and Cox proportional hazards regression models were used to assess survival and failure rates.

Main Results:

  • 131 patients underwent salvage fusion post-TAA failure, with a mean follow-up of 47.5 months.
  • Overall, 22.1% of fusions failed, with 18.3% requiring revision and 3.8% resulting in amputation.
  • One-year survival was 96.0%, and three-year survival was 77.5%, with most failures occurring within the first three postoperative years.

Conclusions:

  • Salvage ankle fusion following TAA failure demonstrates moderate survival rates but is associated with significant reoperation and failure rates.
  • Approximately 25% of patients required revision surgery within three years of the salvage fusion.
  • These findings highlight the need for careful patient selection and management in revision TAA cases.