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Long-term follow-up of Bologna-Oxford (BOX) total ankle arthroplasty

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Abstract

Purpose

The purpose of this retrospective study was to evaluate the long-term results with a minimum of ten years follow-up of primary Bologna-Oxford (BOX) TAA.

Methods

Between December 2004 and December 2009, 80 patients (82 ankles) underwent a primary BOX TAA performed by a single senior surgeon, expert in foot and ankle surgery. Pain and functional outcomes were analysed using Visual Analogue Scale (VAS) for pain, American Orthopaedic Foot & Ankle Society (AOFAS) scoring system, Foot Functional Index Disability and Pain (FFI-Disability, FFI-Pain) score for comparative analysis.

Results

A total of 52 patients (54 implants) in a cohort of 80 (82 implants) were examined at a minimum ten years follow-up. Twenty implants out of 54 underwent implant failure (37 %) and 34 patients were enrolled in the present study. The mean VAS for pain decreased significantly from 8.5 ± 1.2 to 2.9 ± 2.2 (p<0.01) and the mean AFOAS score changed from 28.6 ± 11.8 pre-operatively to 72.7 ± 16.9 (p<0.01) at last follow-up. Ninety-seven percent was satisfied with a mean FFI-Disability score that improved from 77.6 ± 19.3 to 26.7 ± 25.4 (p<0.01) and FFI-Pain score that decreased from 76.2 ± 14.2 to 31.4 ± 25.6 (p<0.01). We calculated post-operative alignment using alpha, beta and gamma angles with no difference at long-term follow-up. The survival rate of the implant was 66% at ten years of follow-up.

Conclusions

Our data suggest that BOX TAA is an implant with a good patient satisfaction rate at long-term follow-up; therefore, it is a valid option to increase the quality of life in subjects with end-stage osteoarthritis; however, long-term survivorship is unsatisfactory when compared to modern knee and hip implant.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Department of Orthopedics, IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20100, Milan, Italy

    Alberto Bianchi, Nicolò Martinelli, Eleonora Caboni, Francesca Manfroni & Valerio Sansone

  2. Hospital de Urgencia Asistencia Pública, Santiago, Chile

    Giorgio Raggi

  3. Department of Orthopedics, University of Milan, Milan, Italy

    Valerio Sansone

Authors
  1. Alberto Bianchi
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  2. Nicolò Martinelli
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  3. Eleonora Caboni
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  4. Giorgio Raggi
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  5. Francesca Manfroni
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  6. Valerio Sansone
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Contributions

NM and AB contributed to research design, analysis and interpretation of data. EC, GR and FM collected the clinical and radiological data and drafted the first version of the paper. VS contributed to the writing of the discussion section and corrected the first draft of the paper.

Corresponding author

Correspondence to Nicolò Martinelli.

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Ethical approval

All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the local ethical committee.

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Subjects enrolled in the study provided written informed consent to participate in this research.

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Subjects enrolled in the study provided written informed consent to publish the data

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Bianchi, A., Martinelli, N., Caboni, E. et al. Long-term follow-up of Bologna-Oxford (BOX) total ankle arthroplasty. International Orthopaedics (SICOT) 45, 1223–1231 (2021). https://doi.org/10.1007/s00264-021-05033-1

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  • DOI: https://doi.org/10.1007/s00264-021-05033-1

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