International Orthopaedics

, Volume 43, Issue 10, pp 2333–2339 | Cite as

The Bologna-Oxford ankle replacement: a case series of clinical and radiological outcomes

  • Ali NajefiEmail author
  • Karan Malhotra
  • Oliver Chan
  • Nicholas Cullen
  • Andy Goldberg
Original Paper



The Bologna-Oxford (BOX®) total ankle arthroplasty (TAA) is a three-component mobile-bearing implant gaining popularity in Europe. We aimed to analyse the outcomes of this TAA.


We retrospectively analysed data on 34 consecutive BOX® TAAs performed at a single centre with a mean follow-up of 58 months. Radiographic outcomes, such as periprosthetic lucency and alignment, were measured and recorded. Prospectively captured clinical scores and range of movement (ROM) were also recorded.


There were significant improvements in patient-reported outcome scores recorded in the Manchester-Oxford Foot Questionnaire (MOxFQ) for pain (43.8 ± 20.2, p < 0.001), standing and walking (55.6 ± 19.8, p < 0.001), social activities (45.0 ± 26.9, p < 0.02) and visual analogue score (VAS) (3.1 ± 2.5, p < 0.001). Mean improvement in ROM postoperatively was 18.7° (p < 0.001), with post-operative dorsiflexion 8.8° (10°–25°) and plantar flexion 32.6° (20°–40°). There was evidence of asymptomatic lucency on five radiographs (15%), which was present in 10% at three years. Nine patients had complications (26%): six (18%) requiring secondary surgery and one requiring revision (3%) for infection.


We have demonstrated 97% survivorship at a mean of 58 months. There are maintained improvements in clinical and radiological outcomes and reoperation that are consistent with the literature.


Mobile bearing Loosening Range of movement Alignment 



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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  • Ali Najefi
    • 1
    Email author
  • Karan Malhotra
    • 1
  • Oliver Chan
    • 1
  • Nicholas Cullen
    • 1
  • Andy Goldberg
    • 1
    • 2
  1. 1.Foot & Ankle UnitRoyal National Orthopaedic HospitalStanmoreUK
  2. 2.Institute of Orthopaedics and Musculoskeletal ScienceRoyal National Orthopaedic Hospital NHS TrustMiddlesexUK

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