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Study: Talar subsidence found in total ankle arthroplasty systems

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HOLLYWOOD, Fla. — Researchers found talar component subsidence with the use of two generations of a total ankle arthroplasty system, according to study results presented here at the American Orthopaedic Foot and Ankle Society Annual Meeting.

“Component stability is critical for total ankle arthroplasty success,” Jaymes D. Granata, MD, MBA, said. “We developed a standardized X-ray protocol for monitoring implant position and with this we found that the talar component moves over time,” Granata said. “What we do not know is whether or not this is benign settling toward a preferred position or if this is instability that will lead to subsidence failure. Component design does appear to be important with less motion noted in the MO2 design and this is in addition to other key factors for talar stability, such as bone quality and amount of resection.”

 

Jaymes D. Granata

Granata and researchers conducted a retrospective review of 52 patients who had a total ankle arthroplasty (TAA) with either the INBONE I (44 patients) or INBONE II (8 patients) (Wright Medical, Arlington, Tenn.) prostheses between 2008 and 2011. Patients were a mean age of 62 years. The researchers followed the patients up to 19.3 months after surgery.

They created a protocol to measure seven different implant position variables, including  medial, lateral and anterioposterior positions (AP), according to Granata. They examined the anterior and posterior positions, angulation, foot position of the tibia and talar component position of the talonavicular joint.

At the most recent follow-up, the translational and rotational positions of the talar component shifted on AP and lateral planes on radiographs, according to Granata.

“Trends toward less motion were found in the INBONE II group and a decrease in motion was found in the AP translation,” he said.

The researchers found no significant change in the height of the polyethylene, which indicated the movement was implant subsidence and not polyethylene wear, according to Granata.

“There are a number of limitations with this study, including the small sample size and short-term follow-up, but we will continue to monitor these patients through our database and follow their outcomes,” he said.

Reference:

Granata JD. Paper #17. Presented at: American Orthopaedic Foot and Ankle Society Annual Meeting; July 18-20, 2013; Hollywood, Fla.

Disclosure: Granata has no relevant financial disclosures.