Medium to long-term results of 130 Ankle Evolutive System total ankle replacements—Inferior survival due to peri-implant osteolysis. Issue 2 (June 2017)

• Record Type: Journal Article
• Authors: Koivu, Helka; Kohonen, Ia; Mattila, Kimmo; Loyttyniemi, Eliisa; Tiusanen, Hannu
• Is Part Of: Foot and ankle surgery. Volume 23:Issue 2(2017:Jun.)
• Page Start: 108
• Page End: 115
• Publication Date: 2017-06
• Subjects: Total ankle arthroplasty -- AES -- Survival -- Osteolysis -- Malalignment; Foot -- Surgery -- Periodicals; Ankle -- Surgery -- Periodicals; Ankle -- surgery -- Periodicals; Foot -- surgery -- Periodicals; Ankle -- Surgery; Foot -- Surgery; Periodicals; Electronic journals; 617.58
• DOI: 10.1016/j.fas.2017.03.016
• Languages: English
• ISSNs: 1268-7731

Abstract

Highlights: High amount of peri-implant osteolysis with AES total ankle replacement. The outcome and survival of AES TAR is impaired by peri-implant osteolysis. Postoperative varus malalignment is associated with poor implant survival in TAR. Abstract: Background: The study reports the medium to long-term results of 130 Ankle Evolutive System total ankle replacements operated at a single-centre. Previously high amount of peri-implant osteolysis was reported from the same material. Methods: Between 2002 and 2008 one hundred and thirty consecutive ankles replaced with AES ankle prosthesis were followed both radiologically and clinically. Results: The five-year survival was 87.3% (95% confidence interval (CI) 80.0–92.0%), and ten-year survival 74.9% (95% confidence interval (CI) 65.4–82.2%) at a median follow-up time of 96 months (range 2–161; 8 years). Peri-implant osteolysis was found in 91 (70%) ankles, marked in 78 (60%). 44 ankles (34%) have been revised by filling of the cavities, 24 (18%) by fusion, and 6 by further replacement, resulting in the revision rate of 58%. Osteolysis was the main reason for all revisions. The improvement of the Kofoed Score and pain points was significant (all p < 0.0001), and the subjective patient satisfaction was good. Conclusions: Outcome of the current study was seriously affected by osteolysis and is inferior compared to previous reports.