Authors:
Pascal
F. Rippstein, MD; Martin Huber, MD; J. Chris Coetzee, MD; Florian D. Naal, MD
Journal: JBJS TAR 3 Component System
Abstract:
Background: Total
ankle arthroplasty has evolved over the past decade, and newer three-component
implants have demonstrated favorable clinical results and improved
survivorship. The present study analyzed the clinical and radiographic results
of the first 240 total ankle arthroplasties performed by the authors with one
of these new three-component prostheses. Methods: Two
hundred and forty consecutive primary total ankle arthroplasties were performed
in 233 patients (115 women and 118 men; mean age, 61.6 years) between November
2003 and October 2007 with the Mobility prosthesis. Intraoperative and
postoperative complications, reoperations, and failures were recorded. The
American Orthopaedic Foot & Ankle Society hindfoot score and a visual
analog scale score assessment of pain were determined at each follow-up visit.
Range of ankle motion was measured on functional radiographs, and the
radiographs were studied to assess component positioning, radiolucencies, new
bone formation, and periprosthetic bone cysts. Results: Two hundred and thirty-three of the
arthroplasties were available for follow-up at least one year after surgery.
The mean duration of follow-up was 32.8 ± 15.3 months. There were ten
intraoperative complications (4.2%) and twenty postoperative complications
(8.6%). A reoperation was necessary in eighteen ankles (7.7%). Five
arthroplasties (2.1%) failed at a mean of twenty-seven months after surgery.
The mean American Orthopaedic Foot & Ankle Society hindfoot score improved
from 48.2 to 84.1 points (p < 0.001). The mean pain level decreased from 7.7
to 1.7 points (p < 0.001). The mean total range of ankle motion improved
from 19.8° to 21.9° (p < 0.001). The tibial component had a mean of 2.1° of
varus and a mean posterior slope of 6.0° relative to the tibial axis. The
prevalence of nonprogressive radiolucency ranged from 1.8% to 37.3% in the ten
zones surrounding the tibial component, and from 0 to 2.2% in the three zones
surrounding the talar component. Conclusions: The
short-term clinical and radiographic results after Mobility total ankle
arthroplasty are encouraging and are at least comparable with those associated
with other modern three-component implants. The minimum duration of follow-up
of one year is short, and studies with longer follow-up are needed to confirm
our findings.
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