Complications following total ankle arthroplasty: A systematic literature review and meta-analysis. Issue 8 (December 2022)

• Record Type: Journal Article
• Authors: Hermus, J.P.; Voesenek, J.A.; van Gansewinkel, E.H.E.; Witlox, M.A.; Poeze, M.; Arts, J.J.
• Is Part Of: Foot and ankle surgery. Volume 28:Issue 8(2022)
• Page Start: 1183
• Page End: 1193
• Publication Date: 2022-12
• Subjects: Total ankle replacement -- Ankle arthroplasty -- Complications -- Impingement -- Fracture; 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.2022.07.004
• Languages: English
• ISSNs: 1268-7731

Abstract

Abstract: Background: Total ankle arthroplasty (TAA) is increasingly used as a treatment for end-stage ankle arthropathy. However, TAA may be more sensitive to complications, failure and subsequent re-operations compared to ankle arthrodesis. The aim of this systematic review and meta-analysis is to generate an overview of complications of TAA surgery. Methods: PubMed, EMBASE and the Cochrane library were searched between 2000 and 2020 to identify all papers reporting on complications in TAA surgery. Meta-analysis was conducted based on type of complication in TAA surgery. Pooled estimates of complications were calculated using a random effects model. Risk of bias and quality was assessed using the Cochrane risk of bias and ROBINS-I tools. The confidence in estimates was rated and described according to the recommendations of the GRADE working group. Results: One hundred twenty-seven studies were included in this systematic review. All combined, they reported on 16.964 TAAs with an average follow-up of 47.99 ± 29.18 months. Complications with highest reported pooled incidence were intra-operative fracture 0.06 (95 %CI 0.04–0.08) (GRADE Very low) and impingement 0.06 (95 %CI 0.04–0.08) (GRADE low) respectively. Conclusion: Reported complication incidence of TAA surgery is still high and remains a significant clinical problem that can be severely hampering long-term clinical survival of the prosthesis. The results of this systematic review and meta-analysis can help guide surgeons in informing their patient about complication risks. Implementation of more stringent patient selection criteria might contribute to diminishing TAA complication rates.