Fixed-bearing total ankle prostheses may have lower revision rates vs. mobile-bearing
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Key takeaways:
- Fixed-bearing prostheses had lower revision rates than mobile-bearing prostheses.
- Mobile-bearing prostheses with surface coating had higher revision rates at all intervals measured.
LOUISVILLE, Ky. — Fixed-bearing prostheses may have lower cumulative revision rates compared with mobile-bearing prostheses in total ankle replacement, regardless of surface coating, according to data presented here.
Peter Stavrou, MBBS, FRACS, and colleagues reviewed data from the Australian Orthopaedic Association National Joint Replacement Registry for 1,865 primary cementless total ankle replacement procedures performed between 2015 and 2021 to determine whether insert mobility or hydroxyapatite surface coating were associated with a change in total ankle replacement revision rates. Researchers categorized total ankle replacement procedures by insert mobility (fixed-bearing vs. mobile-bearing) and surface coating (hydroxyapatite vs. non-hydroxyapatite).
“The time to first survivorship was summarized using the Kaplan-Meier estimate of survivorship,” Stavrou said. “Hazard ratios were obtained with Cox proportional hazards models and these hazard ratios were adjusted for age, gender, insert mobility and surface coating.”
Stavrou said the fixed-bearing prosthesis had a statistically significant lower rate of revision at 6 years compared with the mobile-bearing prosthesis. Although patients with a non-hydroxyapatite surface coating had a lower revision rate at 4 years, Stavrou said the result was not statistically significant. He added mobile-bearing prostheses with hydroxyapatite had a substantially higher revision rate at all intervals measured.
“When we compare mobile bearing with hydroxyapatite and fixed bearing with hydroxyapatite, there is a statistically significant difference in revision rates,” Stavrou said. “This also holds true when we compare mobile-bearing [with] hydroxyapatite with fixed-bearing with no hydroxyapatite. When we compare fixed bearing with or without hydroxyapatite there is no difference, statistically.”
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Stavrou P, et al. Fixed bearing in primary total ankle replacement is associated with reduced revision rates. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 20-23, 2023; Louisville, Kentucky.
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