1
|
van der Plaat LW, Hoornenborg D, Sierevelt IN, van Dijk CN, Haverkamp D. Ten-year revision rates of contemporary total ankle arthroplasties equal 22%. A meta-analysis. Foot Ankle Surg 2022; 28:543-549. [PMID: 34116950 DOI: 10.1016/j.fas.2021.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 04/30/2021] [Accepted: 05/31/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The National Institute for Health and Care Excellence criterion for hip replacements is a (projected) revision rate of less than 5% after 10 years. No such criterion is available for ankle prostheses. The objective of the current study is to compare survival rates of contemporary primary ankle prostheses to the hip-benchmark. METHODS The PRISMA methodology was used. Eligible for inclusion were clinical studies reporting revision rates of currently available primary total ankle prostheses. Data was extracted using preconstructed forms. The total and prosthesis-specific annual revision rate was calculated. RESULTS Fifty-seven articles of eight different ankle prostheses were included (n = 5371), totaling 513 revisions at an average 4.6 years of follow-up. An annual revision rate of 2.2 was found (i.e. an expected revision rate of 22% at 10 years). CONCLUSIONS The expected 10-year revision rate of contemporary ankle prostheses is lower than the current benchmark for hip prostheses.
Collapse
Affiliation(s)
- Laurens W van der Plaat
- Department of Orthopedics and Traumatology, St.-Antonius-Hospital Kleve, Albersallee 5-7, 47533 Kleve, Germany.
| | - Daniël Hoornenborg
- Department of Orthopedics, Xpert Orthopedics and Specialized Centre of Orthopedic Research and Education (SCORE), Laarderhoogtweg 12, 1101 EA Amsterdam, The Netherlands
| | - Inger N Sierevelt
- Department of Orthopedics, Xpert Orthopedics and Specialized Centre of Orthopedic Research and Education (SCORE), Laarderhoogtweg 12, 1101 EA Amsterdam, The Netherlands
| | - C Niek van Dijk
- Department of Orthopedics, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Daniël Haverkamp
- Department of Orthopedics, Xpert Orthopedics and Specialized Centre of Orthopedic Research and Education (SCORE), Laarderhoogtweg 12, 1101 EA Amsterdam, The Netherlands
| |
Collapse
|
2
|
Kasai T, Yasui T, Matsumoto T, Tanaka Y, Takakura Y, Tanaka S. Synovial Metallosis After Ceramic Total Ankle Arthroplasty Treated With a Total Talar Prosthesis: A Case Report. J Foot Ankle Surg 2019; 58:1010-1013. [PMID: 31474391 DOI: 10.1053/j.jfas.2018.12.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Indexed: 02/03/2023]
Abstract
Total ankle arthroplasty is a useful surgical procedure for osteoarthritis of the ankle, but aseptic loosening of components is an issue. We report here a case of aseptic implant loosening with metallosis after total ankle arthroplasty using the TNK ankle (Kyocera, Kyoto, Japan), which occurred despite the components being ceramic. We also report favorable results from our method of treatment using a total talar prosthesis in the revision surgery. During the revision surgery, synovial metallosis was found, probably related to superficial damage to the screw affixing the tibial component to the bone. Because both the tibial and talar components were loose, all the components and the remaining talar bone were removed. A new tibial component and a custom-made alumina-ceramic total talar prosthesis was inserted. Pain relief was achieved and maintained through the latest follow-up visit at 42 months after revision surgery. Dorsiflexion of the ankle improved from 0° to 5° and plantarflexion remained unchanged from its preoperative range of 20°. The American Orthopaedic Foot & Ankle Society ankle-hindfoot score improved from 38 to 80 points. To the best of our knowledge, this is the first reported case of an alumina-ceramic total ankle prosthesis loosening caused by metallosis resulting from screw abrasion. Favorable treatment results were obtained by using a total talar prosthesis in the revision surgery.
Collapse
Affiliation(s)
- Taro Kasai
- Surgeon, Department of Orthopedic Sugery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Tetsuro Yasui
- Associate Professor, Department of Orthopedic Surgery, Teikyo University Hospital Mizonokuchi, Kanagawa, Japan; Lecturer, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Takumi Matsumoto
- Attending Surgeon, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuhito Tanaka
- Professor, Department of Orthopedic Surgery, Nara Medical University, Nara, Japan
| | - Yoshinori Takakura
- Professor Emeritus, Department of Orthopedic Surgery, Nara Medical University, Nara, Japan
| | - Sakae Tanaka
- Professor, Department of Orthopedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
3
|
Tan SM, Bin Abd Razak HR, Singh Rikhraj I. Early Functional, Radiological Outcomes and Satisfaction Rates of Total Ankle Arthroplasty in an Asian Population. Foot Ankle Spec 2018; 11:425-432. [PMID: 29325423 DOI: 10.1177/1938640017750252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Few studies have outlined the outcomes and complications in Asians undergoing total ankle arthroplasty. This study reports the functional, radiological outcomes and satisfaction rates in our Asian population. METHODS Patients who underwent primary total ankle arthroplasty from 2007 to 2013 were recruited. Outcomes evaluated were the AOFAS Ankle-Hindfoot Score (AHS), Visual Analogue Scale (VAS), and the Short Form 36 (SF-36)questionnaire. Outcome scores were collected prospectively up to 2 years. Patient satisfaction was evaluated on a 6-point scale based on North American Spine Society Low Back Pain Instrument and classified as satisfied or unsatisfied. RESULTS Forty-one patients underwent primary total ankle arthroplasty. All patients experienced improvements in AHS, VAS, and Mental Component Summary score of the SF-36 at both 6-month and 2-year postoperative interval. The mean AHS score improved from 35 ± 19 points preoperatively to 64 ± 24 at 6 months (P<.001) and 72 ± 26 at 24 months (P <.001). VAS scores improved from 7 ± 2 preoperatively to 3 ± 3 (P < .001) at 6 and 24 months. The Physical Component Summary (PCS) of the SF-36 has an established minimum clinically important difference (MCID) of 5. The mean improvement in PCS in our cohort met this MCID for the PCS; 63% and 71% of patients were satisfied with the procedure at 6 months and 2 years postoperatively, respectively. Revision rate in this series was 9.7%. CONCLUSION Total ankle arthroplasty has good patient satisfaction rates, with favorable early clinical outcome in Asian patients. LEVELS OF EVIDENCE Therapeutic, Level II.
Collapse
Affiliation(s)
- Shi Ming Tan
- Orthopaedic Surgery, Singapore General Hospital, Singapore
| | | | | |
Collapse
|
4
|
Certolizumab pegol was effective for treating residual synovitis after total knee arthroplasty in a patient with rheumatoid arthritis: therapeutic monitoring by ultrasound. J Med Ultrason (2001) 2017; 45:371-374. [DOI: 10.1007/s10396-017-0806-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 06/30/2017] [Indexed: 11/26/2022]
|
5
|
The mid-term outcome of total ankle arthroplasty and ankle fusion in rheumatoid arthritis: a systematic review. BMC Musculoskelet Disord 2013; 14:306. [PMID: 24161014 PMCID: PMC4231459 DOI: 10.1186/1471-2474-14-306] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 09/19/2013] [Indexed: 12/02/2022] Open
Abstract
Background While arthrodesis is the standard treatment of a severely arthritic ankle joint, total ankle arthroplasty has become a popular alternative. This review provides clinical outcomes and complications of both interventions in patients with rheumatoid arthritis. Methods Studies were obtained from Pubmed, Embase and Web of Science (January 1980 – June 2011) and additional manual search. Inclusion criteria: original clinical study, > 5 rheumatoid arthritis (population), internal fixation arthrodesis or three-component mobile bearing prosthesis (intervention), ankle scoring system (outcome). The clinical outcome score, complication- and failure rates were extracted and the methodological quality of the studies was analysed. Results 17 observational studies of 868 citations were included. The effect size concerning total ankle arthroplasty ranged between 1.9 and 6.0, for arthrodesis the effect sizes were 4.0 and 4.7. Reoperation due to implant failure or reoperation due to non-union, was 11% and 12% for respectively total ankle arthroplasty and arthrodesis. The methodological quality of the studies was low (mean 6.4 out of a maximum of 14 points) and was lower for arthrodesis (mean 4.8) as compared to arthroplasty (mean 7.8) (p = 0.04). Conclusions 17 observational and no (randomized) controlled clinical trials are published on the effectiveness of arthroplasty or arthrodesis of the ankle in rheumatoid arthritis. Regardless of the methodological limitations it can be concluded that both interventions show clinical improvement and in line with current literature neither procedure is superior to the other.
Collapse
|
6
|
Angthong C, Chumchuen S, Khadsongkram A. A systematic review of intermediate-term outcomes and failure rates for total ankle replacements: an Asian perspective. Foot Ankle Surg 2013; 19:148-54. [PMID: 23830161 DOI: 10.1016/j.fas.2013.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/10/2013] [Accepted: 04/18/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND There are few records for total ankle replacement (TAR) in Asia. We aimed to report the cumulative intermediate-term outcomes in terms of clinical scores, survivorship and failure rates for patients managed with TAR in Asia. METHODS We conducted a systematic search for relevant articles published in English and other languages between January 1990 and February 2012. The study published before 1990 and used outdated prosthesis designs implanted before the early 1980s was excluded. Eligible studies were evaluated using the Coleman Methodology Score and data collection was independently performed by three reviewers. RESULTS Seven studies qualified for analysis, describing 321 implants (112 HINTEGRA(®), 104 TNK, 35 STAR, 13 ND-Bioceram, 57 un-reported implants). Overall studies showed the improvement of clinical scores following TAR. Pooled data for the survivorship analysis ranged from 100% at 3.2 years to 77% at 14.1 years. Pooled mean failure rate was 4.9±3.2% over a mean follow-up of 5.2±1.7 years. CONCLUSIONS TAR prostheses currently used in Asia achieved satisfactory intermediate-term outcomes in terms of clinical scores, survivorship and failure rates.
Collapse
Affiliation(s)
- Chayanin Angthong
- Department of Orthopaedic Surgery, Faculty of Medicine, Thammasat University, Pathum Thani 12120, Thailand.
| | | | | |
Collapse
|
7
|
Valderrabano V, Pagenstert GI, Müller AM, Paul J, Henninger HB, Barg A. Mobile- and fixed-bearing total ankle prostheses: is there really a difference? Foot Ankle Clin 2012; 17:565-85. [PMID: 23158371 DOI: 10.1016/j.fcl.2012.08.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Approximately 1% of the world's adult population is affected by ankle osteoarthritis (OA). Therapeutic options include conservative and surgical measures. Because of substantial progress in total ankle replacement, ankle fusion is no longer the "gold standard" therapy for end-stage ankle OA. Various ankle prostheses have been designed and are currently available. This article reviews the in vitro studies addressing the biomechanics and kinematics of the replaced ankle. Furthermore, a systematic literature review was conducted to assess possible differences in clinical outcomes, including prosthesis survivorship and postoperative range of motion between mobile- and fixed-bearing total ankle prostheses.
Collapse
Affiliation(s)
- Victor Valderrabano
- Orthopaedic Department, University Hospital of Basel, University of Basel, Spitalstrasse 21, Basel CH-4031, Switzerland.
| | | | | | | | | | | |
Collapse
|
8
|
Hintermann B, Knupp M, Zwicky L, Barg A. Total ankle replacement for treatment of end-stage osteoarthritis in elderly patients. J Aging Res 2012; 2012:345237. [PMID: 22720158 PMCID: PMC3375014 DOI: 10.1155/2012/345237] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 04/19/2012] [Indexed: 01/05/2023] Open
Abstract
End-stage osteoarthritis of the ankle is a disabling problem, particularly in elderly patients who experience an overall loss of mobility and functional impairment and who then need compensatory adaption. Ankle arthrodesis, which has been demonstrated to provide postoperative pain relief and hindfoot stability, leaves the patient with a stiff foot and gait changes. For elderly patient, these changes may be more critical than generally believed. Additionally, the long duration of healing and rehabilitation process needed for ankle arthrodesis may be problematic in the elderly. In contrast to ankle arthrodesis, total ankle replacement has significant advantages including a less strenuous postoperative rehabilitation and preservation of ankle motion which supports physiological gait. Recently, total ankle replacement has evolved as a safe surgical treatment in patients with end-stage ankle osteoarthritis with reliable mid- to long-term results. Total ankle replacement needs less immobilization than arthrodesis and does allow for early weight-bearing and should be considered as a treatment option of first choice in many elderly patients with end-stage osteoarthritis of the ankle, especially in elderly patients with lower expectations and physical demands.
Collapse
Affiliation(s)
| | | | | | - Alexej Barg
- Clinic of Orthopaedic Surgery, Kantonsspital Liestal, 4410 Liestal, Switzerland
| |
Collapse
|
9
|
Shinomiya F, Mima N, Hamada Y, Fuzimura T, Matsumoto S, Okada M, Hamada D. Long-term outcome of patients with rheumatoid arthritis treated by multiple arthroplasty. Mod Rheumatol 2006; 15:241-8. [PMID: 17029072 DOI: 10.1007/s10165-005-0403-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2005] [Accepted: 05/02/2005] [Indexed: 10/25/2022]
Abstract
We conducted a study of 82 patients with rheumatoid arthritis (RA) who had undergone multiple arthroplasty and investigated their clinical findings and clinical courses. We reviewed the significance of multiple arthroplasty in the treatment of RA, its problems, and measures to solve them. All patients initially regained and maintained good walking capacity. However, the walking capacity of many patients again decreased over the long term; in the tenth year, 79% of patients were capable of a practical gait. The causes of decreased walking capacity included complications of artificial joints, cervical lesions, and vertebral compression fractures. Fractures were observed in as many as nine patients, indicating that it is important to prevent and treat their cause, that is, osteoporosis. The survival rate was 71% in 10 years. In RA patients, particularly those who have undergone multiple arthroplasty, the major causes of death are infection and rheumatic disease, suggesting that prevention of such diseases should be considered paramount. Appropriate systemic treatment of RA, patient education, and measures against osteoporosis for prevention of complications may preserve the worth of multiple arthroplasty for RA patients with multiple joint destruction.
Collapse
Affiliation(s)
- Fumio Shinomiya
- Centre for Rheumatic Disease, Mima Hospital in Yoshinogawa city, 497 Zyougejima, Kamojima, Yoshinogawa, 776-0013, Japan.
| | | | | | | | | | | | | |
Collapse
|