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Ankle prosthesis relieves all pain in 72% of patients
More than half of patients resumed sports with Hintegra device.
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WASHINGTON — A Swiss and Belgian study of the Hintegra total ankle prosthesis shows that the device may provide patients with greater mobility, less pain and, in many cases, a return to sports.
Of the 134 consecutive ankles examined, 72% of patients said that they were pain-free after operation. Similarly, researchers reported that 82 (61%) participants returned to sports — including swimming, skiing and hiking – and reported an average clinical 37° range of motion. “The AOFAS (American Orthopaedic Foot and Ankle Society) hindfoot score has shown improvement from 39 points up to 86 points significantly,” Victor Valderrabano, MD, said during his presentation at the American Academy of Orthopaedic Surgeons 72nd Annual Meeting. Valderrabano is a staff member of the Kinesiology Research Center and Orthopaedic at the University of Calgary, Canada, who is on exchange from the University of Basel, Switzerland.
Surgeons implanted the prosthesis in 128 patients (134 ankles). Most patients (75%) had posttraumatic osteoarthritis. Other diagnoses included systematic arthritis (12%) and primary osteoarthritis (13%), Valderrabano said.
Researchers followed participants for a mean of 2.6 years and measured surgical outcomes using the Visual Analog Scale (VAS) and fluoroscopy. Patients reported average VAS scores of 2.6 and 34° of motion.
Patients give good ratings
Most participants gave the implant high ratings, while 14% reported moderate satisfaction. Researchers found that only 4% of patients were dissatisfied with the procedure.
Some patients required additional operations. Surgeons performed six Achilles tendon lengthenings and ligament reconstructions. Patients also received 26 arthrodesis and eight osteotomies, Valderrabano said.
Researchers also reported 11 revised ankles. According to Valderrabano, most revisions occurred in early procedures with post-traumatic clients. Investigators also discovered implant loosening in eight patients, but Valderrabano said that the findings were “based on the first design of this ankle, which had at the very beginning a single layer of coating.”
The latest version of the Hintegra (Newdeal SA) offers a double coating of porous titanium and hydroxyapatite, a human bone structure. The Hintegra is anatomically designed: “The talus has a medial radius smaller than the lateral one on the human bone,” Valderrabano said.
“The total ankle replacement, the Hintegra, is an unconstrained three-component mobile-bearing prosthesis having a tibial component and talus component and polyethylene inlay and it’s not cemented,” he said.
For more information:
- Valderrabano V, Hintermann B, Dereymaeker G. Prospective study of the Hintegra total ankle arthroplasty: a 2.6 years follow-up of 134 cases. #127. Presented at the American Academy of Orthopaedic Surgeons 72nd Annual Meeting. Feb. 23-27, 2005. Washington.