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Long-term Outcomes After Total Ankle Arthroplasty: A Systematic Review
Michael S Lee1, Lucas Mathson1, Clark Andrews1
1Medical College of Wisconsin, Milwaukee, WI, USA.
Foot & Ankle Orthopaedics
|November 11, 2024
Summary
Total ankle arthroplasty (TAA) generally improves patient outcomes long-term, but survivorship rates vary significantly. Further research is needed to standardize outcome reporting for TAA.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Rehabilitation Medicine
Background:
- Total ankle arthroplasty (TAA) is a common surgical treatment for ankle arthritis.
- Over 40,000 TAAs were performed in the US between 2009-2019.
- Limited aggregate data exists on long-term patient-reported outcomes (PROs) after TAA.
Purpose of the Study:
- To aggregate and report on minimum 10-year PROs following primary TAA.
- To analyze survivorship rates and implant failure timelines in long-term TAA studies.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searched PubMed, Scopus, and CENTRAL for studies with minimum 10-year PROs or satisfaction post-TAA.
- Included English-language primary research articles; survivorship based on implant failure definitions within each study.
Main Results:
- Eight studies (595 ankles, ages 51-73.7) met inclusion criteria, with follow-up from 10 to 20 years.
- Six studies reported average follow-up between 11.9-15.8 years.
- Two studies showed significant PRO improvement; survivorship ranged from 66%-94.4% at 10 years, with implant failure occurring between 4.6-13.8 years.
Conclusions:
- Primary TAA generally leads to improved PROs at minimum 10-year follow-up.
- Survivorship rates are variable (66%-94.4%) and require cautious interpretation due to differing definitions.
- Standardization of survivorship definitions and PRO reporting is recommended for future analyses.
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