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Revision Total Ankle Arthroplasty Using the INVISION Modular Implant System: A Systematic Review and Meta-Analysis.

Shahabeddin Yazdanpanah¹, Braeden R Gooch², Sashrik Sribhashyam²

¹College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.

Foot & Ankle Orthopaedics

|April 28, 2026

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The INVISION implant for revision total ankle arthroplasty (rTAA) shows 88% survivorship but carries risks of aseptic loosening and infection. No significant differences in reoperation or re-revision were found between INVISION implant combinations.

Area of Science:

Orthopedic surgery
Biomaterials engineering
Medical device technology

Background:

Rising rates of ankle arthritis necessitate advanced solutions for revision total ankle arthroplasty (rTAA).
The INVISION modular implant system offers a novel approach to rTAA challenges, but clinical data is limited.
Understanding INVISION rTAA outcomes is crucial for improving patient care and surgical planning.

Purpose of the Study:

To systematically review and synthesize existing literature on the INVISION implant system in rTAA.
To evaluate implant survivorship and complication rates associated with INVISION rTAA.
To identify key drivers of reoperation and re-revision in INVISION rTAA cases.

Main Methods:

A comprehensive literature search was conducted across major databases (PubMed/MEDLINE, Embase, Cochrane, CINAHL, Web of Science) on August 18, 2025.

Keywords:

INVISION complications implant outcomes reoperation revision survivorship total ankle

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Quality assessment of included retrospective studies was performed using the Methodological Index for Non-Randomized Studies (MINORS).

Data extraction included patient demographics and operative outcomes, with statistical analysis using frequency-weighted means (FWMs) and meta-analyses.

Main Results:

Five retrospective studies involving 100 patients were analyzed, with a mean follow-up of 2.8 years.
Pooled implant survivorship was 88%, with an all-cause rTAA reoperation rate of 21% and re-revision rate of 11%.
Aseptic loosening (38.1%) and infection (28.6%) were primary drivers of reoperation, with no significant risk differences across INVISION implant permutations.

Conclusions:

INVISION rTAA shows early survivorship but requires cautious interpretation due to study design limitations and heterogeneity.
Aseptic loosening and infection are significant concerns impacting reoperation and re-revision rates.
Further longitudinal, comparative studies are necessary to validate these findings and guide future clinical practice.