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Erschienen in: International Orthopaedics 10/2018

20.03.2018 | Original Paper

Total ankle replacement leads to high revision rates in post-traumatic end-stage arthrosis

verfasst von: Yves Gramlich, Oliver Neun, Alexander Klug, Johannes Buckup, Thomas Stein, Arvid Neumann, Sebastian Fischer, Hans-Peter Abt, Reinhard Hoffmann

Erschienen in: International Orthopaedics | Ausgabe 10/2018

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Abstract

Introduction

Extremely heterogeneous revision rates in total ankle arthroplasty (TAA) of the upper ankle joint are reported and result to heterogeneous collectives and to short follow-up times. The aim is to investigate revision rates and the underlying reasons, as well as treatment outcome and quality of life after TAA in post-traumatic cases with sufficient follow-up.

Methods

In 2008–2013, 74 patients with post-traumatic arthrosis were treated using TAA with a Tornier Salto prosthesis, and 60 (35 males and 25 females; mean age 56) were followed-up (mean: 59 months; range 24–91 months).

Results

The revision rate after TAA was 42% (n = 25), and it was 8% after 12 months and 18% after 24 months. Twenty percent of the patients had significant symptomatic periprosthetic bone cysts, 5% had impingement, 3% had soft tissue infections, and, in 14%, revision was caused by other factors. The most commonly performed procedures were cyst debridement and autologous spongy bone grafting (20%). Fifteen percent (n = 9) of the prosthetics were explanted or switched to a tibiotalar arthrodesis (TTA). The mean AOFAS (American Orthopaedic Foot and Ankle Society) score was 55.15 (range 12–100) and the mean FAO (Foot and Ankle Outcome) score was 49.6 (range 18–100). The revision subgroup had impaired outcomes (AOFAS 38.84; FAO 35.5) while the non-revision subgroup had improved outcomes (AOFAS 66.8; FAO 60.48). TAA patients undergoing conversion to TTA had worse outcomes (AOFAS 39; FAO 35.29).

Conclusion

Total ankle replacement in post-traumatic end-stage arthrosis patients is associated with high revision rates. High rates of symptomatic periprosthetic bone cysts caused high rates of revision surgery and worse outcomes, which were not improved by secondary TTA.
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Metadaten
Titel
Total ankle replacement leads to high revision rates in post-traumatic end-stage arthrosis
verfasst von
Yves Gramlich
Oliver Neun
Alexander Klug
Johannes Buckup
Thomas Stein
Arvid Neumann
Sebastian Fischer
Hans-Peter Abt
Reinhard Hoffmann
Publikationsdatum
20.03.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 10/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-3885-z

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