Speaker compares long-term outcomes between total ankle arthroplasty and ankle arthrodesis
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CHARLOTTE, N.C. — Compared with patients who undergo ankle arthrodesis, patients who undergo total ankle arthroplasty had better long-term functional scores but greater revision rates, according to presented results.
“End-stage ankle arthritis has been shown to have an equivalent impact on quality of life as end-stage hip arthritis; however, it is a disease in younger patients. Average age of ankle fusion is 55 [years], whereas that of total knee and total hip arthroplasty is 68 [years],” Evan M. Loewy, MD, said in his presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
Loewy and colleagues performed a retrospective chart review of 198 ankles that received arthrodesis and 137 ankles that received total ankle arthroplasty (TAA) with the Scandinavian total ankle replacement (STAR) prosthesis. Primary outcome measures included the foot function index (FFI) and revision rates. Other measures included perioperative complications, such as polyethylene fracture, and subsequent subtalar fusion for symptomatic adjacent joint arthritis.
At a mean final follow-up of 11.2 years (minimum 6 years), 104 cases had complete functional outcome surveys. Overall, Loewy and colleagues found mean FFI scores were “significantly better” in the TAA group (40.3) compared with the arthrodesis group (61.5). However, 15% of TAA cases (n = 21 ankles) required revisions at a mean of 61.1 months, while 6% of arthrodesis cases (n = 10 ankles) required revision at a mean of 8.9 months.
Additionally, 13 polyethylene components in 12 TAAs (8.7%) were replaced due to fractures at an average of 9.6 years postoperatively. Subsequent subtalar fusion was required in 2.2% (n = 3) TAA cases and in 3.5% (n = 7) arthrodesis cases at an average of 4.9 years postoperatively, the researchers noted.
According to the abstract, the research represents the largest and longest-term follow-up study to compare the STAR prosthesis with ankle arthrodesis in the United States to date.
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Goodson KM, et al. Long-term revision rates and functional outcomes of total ankle arthroplasty and ankle arthrodesis. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting. Sept. 22 - Sept. 25, 2021; Charlotte, N.C.
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