Total ankle replacement implant may yield high retention, low reoperation rates
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Key takeaways:
- The Invision Total Ankle Revision implant had 100% survivorship in patients undergoing primary or revision total ankle replacement.
- Patients had similar improvements in patient-reported outcome measures.
LOUISVILLE, Ky. — Data showed a modular augmented revision implant for total ankle replacement may yield high retention rates, low reoperation rates and significant improvements in patient-reported outcomes for pain and physical function.
“Looking to future studies, we recommend ongoing follow-up and institutional collaboration in order to elucidate the long-term outcomes of the Invision implant (Wright Medical),” Isabel Shaffrey, said in her presentation at the American Orthopaedic Foot & Ankle Society Annual Meeting.
In a retrospective cohort study, Shaffrey and colleagues reviewed data for 26 adult patients who underwent either primary (n=7) or revision (n=19) total ankle replacement with the Invision Total Ankle Revision implant to determine implant survivorship, rates of complication and reoperation, patient-reported outcomes and radiographic outcomes at a minimum 2-year follow-up.
Researchers assessed radiographs for lucency, cyst formation and subsidence at 2-years postoperatively. Researchers also utilized Patient-Reported Outcome Measurement Information System (PROMIS) scores for patient-reported outcomes both preoperatively and at 1- and 2-years postoperatively.
Researchers found 100% implant survivorship at a mean of 3.4 years for the primary cohort and 3.5 years for the revision cohort. Shaffrey said one patient in the primary cohort had an intraoperative complication and two patients required reoperation, while there were no complications or reoperations in the revision cohort.
“[In the primary cohort], we found that there were significant improvements within the PROMIS domains of physical function, pain interference, pain intensity and global physical health at 2 years,” Shaffrey said.
She added patients in the revision cohort experienced similar significant improvements within the PROMIS domains of physical function, pain interference, pain intensity and global physical health at 2 years.
In the radiographic outcomes, Shaffrey said the revision cohort had one asymptomatic lucency and one symptomatic talar subsidence at final follow-up, while the primary cohort had no cases of lucency, cyst formation or subsidence.
“At final follow-up, three of our 19 patients [undergoing revision] were deceased, and four patients had undergone revision surgery prior to this revision,” Shaffrey said. “This indicates that this cohort may represent a vulnerable population with more complex medical and surgical comorbidities than the general total ankle patient population.”
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Shaffrey I, et al. Early survivorship, clinical and radiographic outcomes following primary and revision total ankle arthroplasty using a modular augmented revision (Invision). Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 20-23, 2023; Louisville, Kentucky.
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