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The Salto Total Ankle Arthroplasty: Survivorship and Analysis of Failures at 7 to 11 years

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Despite the appearance of new-generation, mobile-bearing, cementless prostheses, total ankle arthroplasty remains controversial. Among the criteria guiding the choice between arthrodesis and arthroplasty, the long-term survival and postoperative function are of critical importance. The mobile-bearing Salto prosthesis has been used in Europe since 1997, but only 2 to 5 years of followup data have been reported.

Questions/purposes

We analyzed the longer-term survivorship and causes of failures of the Salto prosthesis in a cohort of previously studied patients. We asked whether this prosthesis provided a functional ankle (AOFAS score) and durable radiographic fixation.

Patients and Methods

We retrospectively reviewed 96 prospectively followed patients with 98 prostheses implanted between 1997 and 2000. Of those, 85 patients (87 prostheses) had a minimum followup of 6.8 years (mean, 8.9 years; range, 6.8–11.1 years).

Results

The survival rate was 65% (95% CI, 50–80) with any reoperation of the ankle and 85% (95% CI, 75–95) with revision of a component as the end points. Six prostheses were removed for arthrodesis, and 18 ankles underwent reoperation without arthrodesis. We observed three main causes of reoperations: bone cysts (11 patients), fracture of the polyethylene (five patients), and unexplained pain (three patients). The mean AOFAS score was 79 ± 12 points. Radiographic subsidence was observed in three patients and bone cysts in eight patients.

Conclusions

Our data suggest a high rate of reoperations but only six revisions with arthrodesis with mid-term followup. We observed few patients with loosening and/or subsidence.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Author information

Authors and Affiliations

  1. Centre Orthopédique Santy, 24 Av Paul Santy, 69008, Lyon, France

    Michel Bonnin MD & Jean-Raphael Laurent MD

  2. Centre Hospitalier Raymond Poincarré, 92380, Garches, France

    Fabrice Gaudot MD & Thierry Judet MD

  3. Department of Foot and Ankle Surgery, The Hospital for Special Surgery, New York, NY, USA

    Scott Ellis MD

  4. Clinique de l’Union, 31240, Saint Jean, France

    Jean-Alain Colombier MD

Authors
  1. Michel Bonnin MD
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  2. Fabrice Gaudot MD
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  3. Jean-Raphael Laurent MD
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  4. Scott Ellis MD
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  5. Jean-Alain Colombier MD
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  6. Thierry Judet MD
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Corresponding author

Correspondence to Michel Bonnin MD.

Additional information

One or more authors (MB, JAC and TJ) received royalties from Tornier SA, Montbonnot, France.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research.

This work was performed at Centre Orthopédique Santy, Lyon, France.

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Bonnin, M., Gaudot, F., Laurent, JR. et al. The Salto Total Ankle Arthroplasty: Survivorship and Analysis of Failures at 7 to 11 years. Clin Orthop Relat Res 469, 225–236 (2011). https://doi.org/10.1007/s11999-010-1453-y

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  • DOI: https://doi.org/10.1007/s11999-010-1453-y

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