How Successful are Current Ankle Replacements?: A Systematic Review of the Literature
- First Online:
- 998 Downloads
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.
- 4.Centre for Evidence-Based Medicine. Levels of evidence and grades of recommendation. Available at: http://www.cebm.net/index.aspx?o=1025. Accessed May 18, 2009.
- 6.Coleman BD, Khan KM, Maffulli N, Cook JL, Wark JD. Studies of surgical outcome after patellar tendinopathy: clinical significance of methodological deficiencies and guidelines for future studies. Institute of Sport Tendon Study Group. Scand J Med Sci Sports. 2000;10:2–11.CrossRefPubMedGoogle Scholar
- 25.Moher D, Schulz KF, Altman DG; CONSORT. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol. 2001;1:2.Google Scholar