Total Ankle Arthroplasty: Clinical and Radiographic Outcomes of a Case Series with 10-Year Follow-up
Abstract
Introduction: End-stage ankle osteoarthritis is a major cause of pain and disability. Total ankle arthroplasty (TAA) has emerged as an alternative to arthrodesis, aiming to preserve joint mobility and improve quality of life. However, long-term evidence remains limited. The objective of this study was to evaluate the clinical and radiographic outcomes of a series of patients who underwent TAA with a minimum follow-up of 10 years. Materials and Methods: A retrospective series of patients who underwent TAA between 2007 and 2015 was analyzed. Demographic data, pain assessed using the Visual Analog Scale (VAS), function assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) score, quality of life assessed using the Short Form-36 (SF-36), radiographic findings, and implant survivorship were evaluated. Results: Out of 40 patients, 17 completed the 10-year follow-up. The median VAS score improved from 8 to 3 (p < 0.001). The AOFAS score increased from 36 to 79 points, reaching a maximum of 80 points at 5 years (p < 0.001). The SF-36 demonstrated good to very good results across most domains. Implant survivorship at 10 years was 82%. Conclusion: Total ankle arthroplasty provides sustained pain relief and improves function and quality of lifeat 10 years, supporting its role as a valid alternative to arthrodesis in patients with end-stage ankle osteoarthritis.Downloads
References
Villena DS, Valenti P, Verbner J, Sotelano P, Santini Araujo MG, Conti L, et al. Rol de la alineación de la prótesis y las calcificaciones heterotópicas en la artroplastia total de tobillo. Rev Asoc Argent Ortop Traumatol 2023;88(1):33-44. https://doi.org/10.15417/issn.1852-7434.2023.88.1.1637
Barg A, Pagenstert GI, Hügle T, Gloyer M, Wiewiorski M, Henninger HB, et al. Ankle osteoarthritis: etiology, diagnostics, and classification. Foot Ankle Clin 2013;18(3):411-26. https://doi.org/10.1016/j.fcl.2013.06.001
Glazebrook M, Daniels T, Younger A, Foote CJ, Penner M, Wing K, et al. Comparison of health-related quality of life between patients with end-stage ankle and hip arthrosis. J Bone Joint Surg Am 2008;90(3):499-505. https://doi.org/10.2106/JBJS.F.01299
Brown TD, Johnston RC, Saltzman CL, Marsh JL, Buckwalter JA. Posttraumatic osteoarthritis: A first estimate of incidence, prevalence, and burden of disease. J Orthop Trauma 2006;20(10):739-44. https://doi.org/10.1097/01.bot.0000246468.80635.ef
Clough T, Bodo K, Majeed H, Davenport J, Karski M. Survivorship and long-term outcome of a consecutive series of 200 Scandinavian Total Ankle Replacement (STAR) implants. Bone Joint J 2019;101-B(1):47-54. https://doi.org/10.1302/0301-620X.101B1.BJJ-2018-0801.R1
Abdo RV, Wasilewski SA. Ankle arthrodesis: a long-term study. Foot Ankle 1992;13(6):307-12. https://doi.org/10.1177/107110079201300602
Fuchs S, Sandmann C, Skwara A, Chylarecki C. Quality of life 20 years after arthrodesis of the ankle. A study of adjacent joints. J Bone Joint Surg Br 2003;85(7):994-8. https://doi.org/10.1302/0301-620x.85b7.13984
Hintermann B, Valderrabano V. Total ankle replacement. Foot Ankle Clin 2003;8(2):375-405.
https://doi.org/10.1016/s1083-7515(03)00015-9
Easley ME, Adams SB Jr, Hembree WC, DeOrio JK. Results of total ankle arthroplasty. J Bone Joint Surg Am 2011;93(15):1455-68. https://doi.org/10.2106/JBJS.J.00126
Vickerstaff JA, Miles AW, Cunningham JL. A brief history of total ankle replacement and a review of the current status. Med Eng Phys 2007;29(10):1056-64. https://doi.org/10.1016/j.medengphy.2006.11.009
Kitaoka HB, Alexander IJ, Adelaar RS, A Nunley J, Myerson MS, Sanders M, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 1997;18(3):187-8. https://doi.org/10.1177/107110079701800315
Alonso J, Prieto L, Antó JM. La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin (Barc) 1995;104(20):771-6. PMID: 7783470
Valderrabano V, Hintermann B, Dick W. Scandinavian total ankle replacement: A 3.7-year average followup of 65 patients. Clin Orthop Relat Res 2004;(424):47-56. PMID: 15241143
Villena DS, Sotelano P, Conti L, Parise AC, Santini Araujo G, Carlucci S, et al. Comparación de los resultados de la artroplastia total de tobillo en pacientes ≤55 y >55 años. Rev Asoc Argent Ortop Traumatol 2020;85(4):305-16. https://doi.org/10.15417/issn.1852-7434.2020.85.4.1001
Haddad SL, Coetzee JC, Estok R, Fahrbach K, Banel D, Nalysnyk L. Intermediate and long-term outcomes of total ankle arthroplasty and ankle arthrodesis: a systematic review. J Bone Joint Surg Am 2007;89(9):1899-905. https://doi.org/10.2106/JBJS.F.01149
Saltzman CL, Mann RA, Ahrens JE, Amendola A, Anderson RB, Berlet GC, et al. Prospective controlled trial of STAR total ankle replacement versus ankle fusion: initial results. Foot Ankle Int 2009;30(7):579-96. https://doi.org/10.3113/FAI.2009.0579
Kofoed H, Lundberg-Jensen A. Ankle arthroplasty in patients younger and older than 50 years: a prospective series with long-term follow-up. Foot Ankle Int 1999;20(8):501-6. https://doi.org/10.1177/107110079902000807
Kandala NB, Connock M, Pulikottil-Jacob R, Sutcliffe P, Crowther MJ, Grove A, et al. Setting benchmark revision rates for total hip replacement: analysis of registry evidence. BMJ 2015:350:h756. https://doi.org/10.1136/bmj.h756
Pabinger C, Lothaller H, Portner N, Geissler A. Projections of hip and knee arthroplasty in OECD countries up to 2050. Arch Orthop Trauma Surg 2018;138(6):861-72. https://doi.org/10.1177/1120700018757940
Brunner S, Barg A, Knupp M, Zwicky L, Kapron A, Valderrabano V, et al. The Scandinavian Total Ankle Replacement: long-term, mid-term, and short-term outcome. J Bone Joint Surg Am 2013;95(8):711-8. https://doi.org/10.2106/JBJS.K.01580
Palanca A, Mann RA, Mann JA, Haskell A. Scandinavian total ankle replacement: 15-year follow-up. Foot Ankle Int 2018;39(2):135-42. https://doi.org/10.1177/1071100717738747
Jastifer JR, Coughlin MJ. Long-term follow-up of mobile bearing total ankle arthroplasty in the United States. Foot Ankle Int 2015;36(2):143-50. https://doi.org/10.1177/1071100714550654
Zaidi R, Cro S, Gurusamy K, Siva N, Macgregor A, Henricson A, et al. The outcome of total ankle replacement: a systematic review and meta-analysis. Bone Joint J 2013;95-B(11):1500-7. https://doi.org/10.1302/0301-620X.95B11.31633
Lawton CD, Butler BA, Dekker RG II, Prescott A, Kadakia AR. Total ankle arthroplasty versus ankle arthrodesis—a comparison of outcomes over the last decade. J Orthop Surg Res 2017;12(1):76. https://doi.org/10.1186/s13018-017-0576-1
Bagheri K, Anastasio AT, Poehlein E, Green CL, Aitchison AH, Cantor N, et al. Outcomes after total ankle arthroplasty with an average follow-up of 10 years: A systematic review and meta-analysis. Foot Ankle Surg
;30(1):64-73. https://doi.org/10.1016/j.fas.2023.09.007
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
