Abstract
Computed tomography (CT) derived patient-specific total ankle arthroplasty (TAA) systems
have been utilized for improved accuracy and reproducible implant alignment. The purpose
of the present study was to report the overall implant survivorship as well as radiographic
analysis of patients who underwent primary TAA utilizing CT-derived patient-specific
instrumentation. A retrospective review of medical charts and radiographs were performed
on patients who had undergone primary TAA at a single institution in the Midwest region
from March 2013 to October 2020. Radiographic analysis included preoperative, initial
postoperative, and final follow-up coronal and sagittal tibiotalar alignment as well
as periprosthetic radiolucency. A total of 96 patients with a mean follow-up of 3
years (range, 0.3-7.3 years) were included. Implant survivorship was found to be 92%
at median follow-up of 3 years. A total of 8 cases (8.3%) required revision/reoperation,
with 6 (6.3%) of these reoperations directly related for failure of one of the metallic
implant components. There was significant improvement in both coronal and sagittal
tibiotalar alignment from preoperative to initial postoperative follow-up (p < .001). At latest postoperative follow-up, there were 88% of TAAs that remained
in a neutral alignment following surgery. A total of 10 cases were found to have radiolucency
at latest follow-up. In conclusion, the use of CT derived patient-specific TAA showed
high implant survivorship with significant improvement of sagittal and coronal tibiotalar
alignment. With better implant alignment and position, it potentially reduces the
risk of early implant failure or implant loosening in long-term follow-up.
Level of Clinical Evidence
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Comparison of health-related quality of life between patients with end-stage ankle and hip arthrosis.J Bone Joint Surg Am. 2008; 90 (PMID:18310699): 499-505
- Impact of comorbidities on the measurement of health in patients with ankle osteoarthritis.J Bone Joint Surg Am. 2006; 88 (PMID:17079392): 2366-2372
- Trends in treatment of advanced ankle arthropathy by total ankle replacement or ankle fusion.Foot Ankle Int. 2014; 35 (PMID:24357680): 216-224
- Comparison of practice patterns in total ankle replacement and ankle fusion in the United States.Foot Ankle Int. 2013; 34 (PMID:23774468): 1486-1492
- Clinical outcomes of total ankle arthroplasty versus ankle arthrodesis for the treatment of end-stage ankle arthritis in the last decade: a systematic review and meta-analysis.J Foot Ankle Surg. 2020; 59 (PMID:32709528): 1032-1039
- The salto total ankle arthroplasty - clinical and radiological outcomes at five years.Foot Ankle Surg. 2019; 25 (PMID:30321952): 523-528
- The infinity total ankle system: early clinical results with 2- to 4-year follow-up.Foot Ankle Spec. 2019; 12 (PMID:29865886): 159-166
- Survival of the Scandinavian total ankle replacement (STAR): results of ten to nineteen years follow-up.Int Orthop. 2017; 41 (PMID:28744802): 2075-2082
- Results at a minimum follow-up of 5 years of a ligaments-compatible total ankle replacement design.Foot Ankle Surg. 2017; 23 (PMID:28578794): 116-121
- Long-term results of Scandinavian total ankle replacement.Foot Ankle Int. 2017; 38 (PMID:28535724): 723-731
- Midterm results of the salto talaris total ankle arthroplasty.Foot Ankle Int. 2017; 38 (PMID:28750551): 1215-1221
- The effect of obesity on functional outcomes and complications in total ankle arthroplasty.Foot Ankle Int. 2016; 37 (PMID:26377200): 137-141
- Early to mid-term results of fixed-bearing total ankle arthroplasty with a modular intramedullary tibial component.J Bone Joint Surg Am. 2014; 96 (PMID:25471913): 1983-1989
- HINTEGRA total ankle replacement: survivorship analysis in 684 patients.J Bone Joint Surg Am. 2013; 95 (PMID:23824385): 1175-1183
- Prospective study of a cementless, mobile-bearing, third generation total ankle prosthesis.Foot Ankle Int. 2011; 32 (PMID:22049861): 755-763
- History and evolution in total ankle arthroplasty.Br Med Bull. 2009; 89 (PMID:19008282): 111-151
- Total ankle replacement: medium-term results in 200 Scandinavian total ankle replacements.J Bone Joint Surg Br. 2008; 90 (PMID:18450626): 605-609
- Ankle arthroplasty and ankle arthrodesis: gait analysis compared with normal controls.J Bone Joint Surg Am. 2013; 95 (e191PMID:24352777): 1-10
- Hindfoot arthritis progression and arthrodesis risk after total ankle replacement.Foot Ankle Int. 2017; 38 (PMID:28810805): 1183-1187
- Radiographic outcomes of preoperative CT scan-derived patient-specific total ankle arthroplasty.Foot Ankle Int. 2015; 36 (PMID:25941196): 1163-1169
- Accuracy and reproducibility using patient-specific instrumentation in total ankle arthroplasty.Foot Ankle Int. 2017; 38 (PMID:27920333): 412-418
- Total ankle arthroplasty accuracy and reproducibility using preoperative CT scan-derived, patient-specific guides.Foot Ankle Int. 2014; 35 (PMID:24719401): 665-676
- Differences in outcomes following total ankle replacement in patients with neutral alignment compared with tibiotalar joint malalignment.J Bone Joint Surg Am. 2013; 95 (PMID:24196462): 1927-1934
- Total ankle arthroplasty in inflammatory joint disease with use of two mobile-bearing designs.J Bone Joint Surg Am. 2006; 88 (PMID:16757761): 1272-1284
- Ankle arthroplasty with preoperative coronal plane deformity: short-term results.Clin Orthop Relat Res. 2004; 424 (PMID:15241149): 98-103https://doi.org/10.1097/01.blo.0000132248.64290.52
- Determining the cost-savings threshold and alignment accuracy of patient-specific instrumentation in total ankle replacements.Foot Ankle Int. 2017; 38 (PMID:27649973): 49-57
- Total ankle arthroplasty: minimum follow-up policy for reporting results and guidelines for reporting problems and complications resulting in reoperations.Foot Ankle Int. 2017; 38 (PMID:28682140): 703-704
- Early prospective clinical results of a modern fixed-bearing total ankle arthroplasty.J Bone Joint Surg Am. 2013; 95 (PMID:23780538): 1002-1011
- The infinity total ankle prosthesis: outcomes at short-term follow-up.Foot Ankle Spec. 2022; 15 (PMID:32772552)1938640020946199
- Increased early revision rate with the infinity total ankle prosthesis.Foot Ankle Int. 2019; 40 (PMID:30175612): 9-17
- Scandinavian total ankle replacement: a 3.7-year average follow-up of 65 patients.Clin Orthop Relat Res. 2004; 424 (PMID:15241143): 47-56
- Accuracy assessment of measuring component position after total ankle arthroplasty using a conventional method.J Orthop Surg Res. 2017; 12 (PMID:28756766): 115
- Total ankle replacement in patients with significant preoperative deformity of the hindfoot.J Bone Joint Surg Br. 2009; 91 (PMID:19336808): 481-486
- Comparison of intermediate to long-term outcomes of total ankle arthroplasty in ankles with preoperative varus, valgus, and neutral alignment.J Bone Joint Surg Am. 2018; 100 (PMID:29762278): 835-842
- A prospective study of four total ankle arthroplasty implants by non-designer investigators.J Bone Joint Surg Am. 2017; 99 (PMID:28196036): 342-348
- Conversion of tibiotalar arthrodesis to total ankle arthroplasty.J Bone Joint Surg Am. 2015; 97 (PMID:26677234): 2004-2013
- Effect of diabetes mellitus on perioperative complications and hospital outcomes after ankle arthrodesis and total ankle arthroplasty.Foot Ankle Int. 2015; 36 (PMID:25413307): 258-267
- Short-term complications, reoperations, and radiographic outcomes of a new fixed-bearing total ankle arthroplasty.Foot Ankle Int. 2018; 39 (PMID:29589784): 787-794
- Intermediate-term outcomes of a third-generation, 2-component total ankle prosthesis.Foot Ankle Int. 2021; 42 (PMID:33508961): 935-943
Article info
Publication history
Published online: September 06, 2022
Footnotes
Investigation Performed at: Sanford Health, Fargo, ND, USA.
Financial Disclosure: No funding was utilized for this study.
Conflict of Interest: This study received no external support. The authors received no payment, personal benefit, commitments, or agreements related to the research. No benefits of any form were received or will be received from a commercial party directly or indirectly to this study. There is no conflict of interest between the authors.
Identification
Copyright
© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
