The talar body prosthesis treated end-stage ankle arthritis with talar body deficient: a 6-13 years of follow-up outcomes and 6-year survivorship

Arch Orthop Trauma Surg. 2022 Nov;142(11):3083-3091. doi: 10.1007/s00402-021-03928-7. Epub 2021 May 8.

Abstract

Introduction: Talar body deficient provides a unique challenge for ankle arthritis treatment. We studied the clinical-radiographic outcomes at 6 to 13 years and 6 year prosthesis survivorship of patients treated for ankle arthritis with poor talar body bone stock using a talar body prosthesis (TBP).

Materials and methods: Between 2008 and 2015, we treated 32 consecutive end-stage ankle arthritis patients with talar body deficiency by TBP implantation and fascia interposition. One patient was excluded with a diagnosis of inflammatory arthritis. We assessed visual analogue scale (VAS) of ankle pain, sagittal range of motion, American Orthopaedics Foot and Ankle Society (AOFAS) ankle-hindfoot score, Foot Ankle Ability Measure (FAAM) of activity daily living (ADL), prosthesis tibiotalar surface angle, radiographic prosthesis loosening, adjacent joint arthritis and complication. Pre-operative to last follow-up outcomes (at 6-13 years) were compared. Prosthesis survivorship was analyzed at 6 year follow-up. p < 0.05 was considered a significant difference.

Results: There was statistically significant improvement of median VAS ankle pain, as 8.0 (IQR 1.0) to 1.0 (IQR 2.0), AOFAS ankle-hindfoot score from 48 (IQR 21) to 80 (IQR 7.0), FAAM of ADL from50.0 (28.0) to 88.0 (IQR 15.0), and sagittal ROM from 20o (IQR 19°) to 33° (IQR 14°), p < 0.05. The median tibiotalar surface angle was statistically significant improved from 85.0° (IQR 8.0°) to 89.0° (IQR 3.0°), p < 0.001. No radiographic prosthesis loosening or adjacent talonavicular-calcaneocuboid joint arthritis. The 6 year prosthesis survivorship was 93.5% (95% CI 84.9-100.0%). End of survivorship was observed in 2 patients due to progressive valgus tilting at 16° and 18°, respectively. No prosthesis was revised.

Conclusions: TBP implantation with fascia replacing the articular end of distal tibia provided significant better pre- to post-operative clinical outcomes and had 6 year survivorship as 93.5% for the treatment of ankle arthritis with talar body deficient.

Level of evidence: IV.

Keywords: 6 year survivorship; End-stage ankle arthritis; Outcomes; Talar body deficient; Talar body prosthesis.

MeSH terms

  • Ankle / surgery
  • Ankle Joint / surgery
  • Arthritis* / etiology
  • Arthritis* / surgery
  • Arthroplasty, Replacement, Ankle*
  • Follow-Up Studies
  • Humans
  • Pain / surgery
  • Prosthesis Failure
  • Retrospective Studies
  • Survivorship
  • Treatment Outcome