A systematic review of intermediate-term outcomes and failure rates for total ankle replacements: an Asian perspective

Background: There are few records for total ankle replacement (TAR) in Asia. We aimed to report the cumulative intermediate-term outcomes in terms of clinical scores, survivorship and failure rates for patients managed with TAR in Asia.

Methods: We conducted a systematic search for relevant articles published in English and other languages between January 1990 and February 2012. The study published before 1990 and used outdated prosthesis designs implanted before the early 1980s was excluded. Eligible studies were evaluated using the Coleman Methodology Score and data collection was independently performed by three reviewers.

Results: Seven studies qualified for analysis, describing 321 implants (112 HINTEGRA(®), 104 TNK, 35 STAR, 13 ND-Bioceram, 57 un-reported implants). Overall studies showed the improvement of clinical scores following TAR. Pooled data for the survivorship analysis ranged from 100% at 3.2 years to 77% at 14.1 years. Pooled mean failure rate was 4.9±3.2% over a mean follow-up of 5.2±1.7 years.

Conclusions: TAR prostheses currently used in Asia achieved satisfactory intermediate-term outcomes in terms of clinical scores, survivorship and failure rates.