Sagittal Tibiotalar Alignment May Not Affect Functional Outcomes in Fixed-Bearing Total Ankle Replacement: A Retrospective Cohort Study.
ankle arthritis
ankle replacement
component alignment
radiologic analysis
total ankle arthroplasty
Journal
HSS journal : the musculoskeletal journal of Hospital for Special Surgery
ISSN: 1556-3316
Titre abrégé: HSS J
Pays: United States
ID NLM: 101273938
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
07
06
2019
accepted:
20
09
2019
entrez:
31
12
2020
pubmed:
1
1
2021
medline:
1
1
2021
Statut:
ppublish
Résumé
In total ankle replacement (TAR), correct positioning of the implant is crucial. Malposition of the components may increase contact pressures and diminish prosthesis survival. The effect of sagittal tibiotalar alignment on functional outcomes after fixed-bearing TAR remains unclear, however, and no studies have compared fixed-bearing implants with respect to the anteroposterior (AP) position of the talar component. The purposes of this study were (1) to evaluate the effect of sagittal tibiotalar alignment on functional outcomes in fixed-bearing TAR and (2) to compare post-operative sagittal tibiotalar alignment in two types of fixed-bearing implants. In a retrospective analysis of 71 primary TARs performed at a single center, we studied the INBONE™ II Total Ankle System and the Salto Talaris Post-operative sagittal tibiotalar alignment was neutral in 39 ankles and anterior in 32 ankles. We observed no significant between-group differences in clinical outcome scores. Patients with a Salto Talaris Ankle prosthesis had a greater AP offset ratio (0.12) than patients with an INBONE II implant (0.05). However, the greater translation did not correlate with outcome scores. At the 2-year follow-up, no correlation between the post-operative AP offset ratio and functional outcome scores was observed between the two fixed-bearing-implant groups. Further studies with longer follow-up are needed to determine whether the difference in sagittal alignment has an effect on functional outcomes in the long term.
Sections du résumé
BACKGROUND
BACKGROUND
In total ankle replacement (TAR), correct positioning of the implant is crucial. Malposition of the components may increase contact pressures and diminish prosthesis survival. The effect of sagittal tibiotalar alignment on functional outcomes after fixed-bearing TAR remains unclear, however, and no studies have compared fixed-bearing implants with respect to the anteroposterior (AP) position of the talar component.
QUESTIONS/PURPOSE
OBJECTIVE
The purposes of this study were (1) to evaluate the effect of sagittal tibiotalar alignment on functional outcomes in fixed-bearing TAR and (2) to compare post-operative sagittal tibiotalar alignment in two types of fixed-bearing implants.
METHODS
METHODS
In a retrospective analysis of 71 primary TARs performed at a single center, we studied the INBONE™ II Total Ankle System and the Salto Talaris
RESULTS
RESULTS
Post-operative sagittal tibiotalar alignment was neutral in 39 ankles and anterior in 32 ankles. We observed no significant between-group differences in clinical outcome scores. Patients with a Salto Talaris Ankle prosthesis had a greater AP offset ratio (0.12) than patients with an INBONE II implant (0.05). However, the greater translation did not correlate with outcome scores.
CONCLUSION
CONCLUSIONS
At the 2-year follow-up, no correlation between the post-operative AP offset ratio and functional outcome scores was observed between the two fixed-bearing-implant groups. Further studies with longer follow-up are needed to determine whether the difference in sagittal alignment has an effect on functional outcomes in the long term.
Identifiants
pubmed: 33380960
doi: 10.1007/s11420-019-09728-5
pii: 9728
pmc: PMC7749918
doi:
Types de publication
Journal Article
Langues
eng
Pagination
300-304Informations de copyright
© Hospital for Special Surgery 2019.
Déclaration de conflit d'intérêts
Conflict of InterestNatalie M. Nielsen, MD, Austin E. Sanders, BA, and Carolyn M. Sofka, MD, declare that they have no conflicts of interest. Guilherme H. Saito, MD, reports fees as a consultant from Wright Medical Technology, outside the submitted work. Scott J. Ellis, MD, reports fees as a consultant from Wright Medical Technology. Constantine A. Demetracopoulos, MD, reports fees as a consultant from Integra LifeSciences and Wright Medical Technology.
Références
Foot Ankle Int. 2016 Mar;37(3):281-7
pubmed: 26443698
Bone Joint J. 2015 Nov;97-B(11):1525-32
pubmed: 26530656
Foot Ankle Clin. 2012 Dec;17(4):707-17
pubmed: 23158378
Foot Ankle Int. 2014 Jan;35(1):22-9
pubmed: 24157645
J Bone Joint Surg Br. 2011 Mar;93(3):293-7
pubmed: 21357948
J Foot Ankle Surg. 2013 May-Jun;52(3):355-9
pubmed: 23522738
J Bone Joint Surg Am. 2014 Apr 2;96(7):e53
pubmed: 24695930
J Bone Joint Surg Am. 2013 Aug 21;95(16):e118(1-9)
pubmed: 23965711
Foot Ankle Int. 2017 Apr;38(4):360-366
pubmed: 28367692
Foot Ankle Int. 2010 Sep;31(9):754-9
pubmed: 20880477
BMC Musculoskelet Disord. 2013 Sep 05;14:260
pubmed: 24007555
Foot Ankle Int. 2006 Feb;27(2):82-7
pubmed: 16487458
Med Care. 1996 Mar;34(3):220-33
pubmed: 8628042
Foot Ankle Int. 2015 Sep;36(9):1029-37
pubmed: 25899099
Skeletal Radiol. 2013 Dec;42(12):1693-701
pubmed: 24026069
J Bone Joint Surg Am. 2011 Nov 2;93(21):1969-78
pubmed: 22048091
J Bone Joint Surg Am. 2010 May;92(5):1179-87
pubmed: 20439664
Foot Ankle Surg. 2016 Sep;22(3):e11-e16
pubmed: 27502236
Foot Ankle Int. 2010 May;31(5):404-11
pubmed: 20460067
Bone Joint J. 2015 May;97-B(5):662-7
pubmed: 25922461
J Bone Joint Surg Am. 2004 Jun;86(6):1172-8
pubmed: 15173289
J Bone Joint Surg Am. 2006 Jun;88(6):1272-84
pubmed: 16757761
J Bone Joint Surg Br. 2005 May;87(5):736-40
pubmed: 15855381
Clin Orthop Relat Res. 2004 Jul;(424):137-42
pubmed: 15241155