Total ankle arthroplasty: long-term survival and factors that influence it

Abstract

TAA and ankle arthrodesis are efficacious treatments of end-stage ankle osteoarthritis but the selection must be specially fit to individual patients. Total ankle arthroplasty (TAA) offers a judicious option to ankle arthrodesis in prudently selected patients. Reoperation rates are greater in TAA compared with ankle arthrodesis. The primary diagnosis for TAA is 37% osteoarthritis, 34% traumatic arthritis, 15% rheumatoid arthritis, 14% other. Patients experiencing TAA tend to be older, female, and have rheumatoid arthritis compared with those being subjected to ankle arthrodesis. Aseptic loosening and infection are the most frequent complications of TAA needing revision. The 15-year survival of primary TAA ranges from 45% to 91%. A comparison between the HINTEGRA implant, the AGILITY implant, the MOBILITY implant, and the Scandinavian Total Ankle Replacement (STAR) implant exhibited reasonable results of four modern TAA designs. TAA is a demanding surgical technique and the survival is not similar to that following hip or knee arthroplasty. Revision TAA has a 10-year survival of 55%, which is lower than the 10-year survival of 74% for primary TAA.