Issue: March 2011
March 01, 2011
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Component loosening led to TAR failures in long-term follow-up

Issue: March 2011

SAN DIEGO — Swiss investigators reported aseptic loosening, talar component subsidence and progressive joint instability as the main factors contributing to the 34.9% revision rate they observed with a three-component total ankle replacement prosthesis.

Samuel Brunner, MD
Samuel Brunner

Samuel Brunner, MD, of Zurich, reported the results of the 10- to-14 year survivorship analysis at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. The study followed 72 patients who underwent total ankle replacement (TAR) with the Scandinavian Total Ankle Replacement (STAR, SBI) System prosthesis.

“Aseptic loosening accounted for 75% of the revisions,” Brunner said.

For the study, Brunner and colleagues defined revision as any component exchange or conversion to ankle fusion.

Thirteen patients (14 ankles) were lost to follow-up. The investigators found that 24 of the 63 remaining ankles (38%) had a revision. “Twenty-two revisions involved an exchange of one or both metallic components, and two were converted to ankle arthrodesis,” Brunner noted.

The investigators found that young age at the time of implantation as a predictor of revision. “Patients with revision were considerably younger at 50.9 years at implantation than those without revision at 58.5 [years],” according to Brunner.

Based on these results, the investigators recommended against the use of hydroxyapatite-coated implants in TAR.

Reference:

  • Brunner S, et al. 10 to 14 year survivorship of a current 3-component total ankle prosthesis. Paper #55. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-19, 2011. San Diego.

Disclosure: Brunner has no relevant disclosures.

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