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Related Concept Videos

Ankle Joint01:10

Ankle Joint

1.8K
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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Updated: Sep 9, 2025

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
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Osteolysis After HINTEGRA Total Ankle Replacement: Radiographic Patterns, Alignment Associations, and Long-Term

Eric Locke1, Roxane Heroux-Legault1, Maram Alothman2,3

  • 1Division of Orthopaedic Surgery, University of Ottawa, Ottawa, ON, Canada.

Foot & Ankle Orthopaedics
|September 3, 2025
PubMed
Summary
This summary is machine-generated.

Osteolysis is common after total ankle replacement (TAR) with the HINTEGRA prosthesis, often appearing years after surgery. Progressive cysts and malalignment may increase revision risk, but most cases do not lead to failure.

Keywords:
HINTEGRAosteolysistotal ankle replacement

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Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Radiology

Background:

  • Total ankle replacement (TAR) is a surgical option for end-stage ankle arthritis.
  • Osteolysis leading to aseptic loosening remains a significant cause of TAR failure.
  • The HINTEGRA prosthesis is a commonly used implant for TAR.

Purpose of the Study:

  • To evaluate the incidence and outcomes of osteolysis after HINTEGRA total ankle replacement.
  • To identify risk factors associated with osteolysis and its clinical sequelae.

Main Methods:

  • Retrospective review of 51 HINTEGRA TARs performed between 2006 and 2014.
  • Radiographic assessment for implant positioning, osteolytic cyst presence, location, and progression.
  • Correlation of osteolysis with reoperation and revision rates.

Main Results:

  • Eighty-four osteolytic cysts were identified in 37 patients over an average follow-up of 5.8 years.
  • Cyst number and size increased with time post-surgery, most commonly in the posterior tibia.
  • Progressive cysts and coronal malalignment were associated with reoperation, though most cysts did not cause clinical failure.

Conclusions:

  • Osteolysis is a frequent radiographic finding in HINTEGRA TARs, particularly with long-term follow-up.
  • Progressive osteolysis and prosthesis malalignment are potential risk factors for implant loosening and reoperation.
  • While most osteolytic lesions are asymptomatic, significant progression warrants close monitoring.