How Successful are Current Ankle Replacements?: A Systematic Review of the Literature
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- Gougoulias, N., Khanna, A. & Maffulli, N. Clin Orthop Relat Res (2010) 468: 199. doi:10.1007/s11999-009-0987-3
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Total ankle arthroplasty provides an alternative to arthrodesis for management of ankle arthritis. What is the outcome of total ankle arthroplasty implants currently in use? We conducted a systematic literature search of studies reporting on the outcome of total ankle arthroplasty. We included peer-reviewed studies reporting on at least 20 total ankle arthroplasties with currently used implants, with a minimum followup of 2 years. The Coleman Methodology Score was used to evaluate the quality of the studies. Thirteen Level IV studies of overall good quality reporting on 1105 total ankle arthroplasties (234 Agility™, 344 STAR, 153 Buechel-Pappas™, 152 HINTEGRA®, 98 Salto™, 70 TNK, 54 Mobility™) were included. Residual pain was common (range, 27%–60%), superficial wound complications occurred in 0% to 14.7%, deep infections occurred in 0% to 4.6% of ankles, and ankle function improved after total ankle arthroplasty. The overall failure rate was approximately 10% at 5 years with a wide range (range, 0%–32%) between different centers. Superiority of an implant design over another cannot be supported by the available data.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.