Mid-term (5–10 year) results of the Salto Talaris total ankle arthroplasty (original) (raw)

Early Prospective Results of the Salto-Talaris™ Total Ankle Prosthesis

Duke orthopaedic journal, 2012

Background: Several fixed-bearing total ankle arthroplasty (TAA) systems are available in the United States (US). We report on the early clinical results of the largest known US cohort of patients who received a Salto-Talaris total ankle replacement for end-stage ankle arthritis. Methods: We prospectively followed 67 TAA patients with a minimum clinical follow-up of 2 years. Patients completed standardized assessments, including visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot score, short form (36) health survey (SF-36), and the short musculoskeletal function assessment (SMFA), along with physical examination, functional assessment, and radiographic evaluation, preoperatively and yearly thereafter through most recent follow-up. Results: Implant survival was 96% using metallic component revision, removal, or impending failure as endpoints, with a mean follow-up of 2.81 years. Three patients developed aseptic loosening, all involving the tibial component. Of these, one underwent revision to another fixed-bearing TAA system, one patient is awaiting revision surgery, and the other patient has remained minimally symptomatic and fully functional without additional surgery. Forty-five patients underwent at least one additional procedure at the time of their index surgery. The most common concurrent procedure performed was a deltoid ligament release (n = 21), followed by removal of previous hardware (n = 16) and gastrocnemius recession (n = 11). Eight patients underwent additional surgery following their index TAA, most commonly debridement for medial and/or lateral impingement (n = 4). Patients demonstrated significant improvement in VAS, AOFAS hindfoot, several SF-36 subscales, SMFA, and functional scores at most recent follow-up (p < 0.001). Conclusion: Early clinical results indicate that the Salto-Talaris fixed-bearing TAA system can provide significant improvement in pain, quality of life, and standard functional measures in patients suffering from end-stage ankle arthritis. The majority of patients underwent at least one concurrent procedure, most commonly to address varus hindfoot deformity, hardware removal, or equinus contracture.

Salto Talaris Total Ankle Arthroplasty

Journal of Bone and Joint Surgery, American Volume, 2016

Background: In recent years, the number of total ankle arthroplasty procedures performed has increased dramatically. We sought to report the clinical results of the largest cohort of patients treated with a modern fixed-bearing total ankle arthroplasty by a single surgeon. Methods: We retrospectively reviewed the charts of 78 consecutive patients (81 ankles) who underwent total ankle arthroplasty with a minimum clinical follow-up of 2 years. Sixty-three patients completed standardized questionnaires including the Foot and Ankle Disability Index (FADI), the Short Musculoskeletal Function Assessment (SMFA), the Short Form (SF)-36v2, and a visual analog scale (VAS) for pain. In addition, each patient underwent serial range-of-motion examination and radiographic implant evaluation at each follow-up appointment. Results: Implant survival was 97.5% at a mean follow-up time of 5.2 years. There was 1 revision of a tibial component and 1 revision of a talar component. Thirty-six patients underwent a concurrent procedure at the time of the index surgery, with the most common being removal of previous hardware. Seventeen patients underwent additional procedures following the index surgery, with the most common being gutter debridement. Total range of motion averaged 35.5°preoperatively and 39.9°p ostoperatively (p = 0.02). Fifty-seven ankles (70%) had >2 years of radiographic follow-up, and 25 ankles (31%) displayed evidence of lucency around a metallic component at the final radiographic follow-up. Outcome scores at a mean of 5.2 years revealed promising results for the cohort, with a mean VAS pain score of 17.7 and a mean FADI score of 79.1. Conclusions: Modern fixed-bearing total ankle arthroplasty had excellent implant survival, improved plantar flexion and total range of motion, and had good-to-excellent functional outcome at a mean follow-up of 5.2 years.

The salto total ankle arthroplasty: Clinical and radiological outcomes at five years

Foot and Ankle Surgery

Aims: Modern designs of total ankle arthroplasty (TAA) have the potential to treat symptomatic ankle OA without adversely affecting ankle biomechanics. We present the mid-term results of a modern, mobile-bearing TAA design. Methods: TAA was performed in 50 consecutive patients (55 ankles) in an independent, prospective, single-centre series. Implant survival, patientreported outcome measures (PROMs) and radiographic outcomes are presented at a mean of five years (range 2-10.5 years). Results: A total of three patients (four ankles) died and two (two ankles) were lost to follow-up. Three TAAs were revised for aseptic loosening (in two cases) or infection. Two further patients underwent reoperations, one for arthroscopic debridement of anterolateral synovitis and one for grafting of an asymptomatic tibial cyst. With all-cause revision as an endpoint, implant survival was 93.3% at five to ten years (95% CI 80.5%-97.8%). If reoperations are included this falls to 90.2% (95% CI 75.6%-96.3%) at five years. No other patient demonstrated radiographic evidence of loosening or subsidence. PROMs and satisfaction were excellent at latest follow-up. Conclusion: At five years, the outcomes for this design of TAA in this series were excellent, and were similar to those of previously published series from the designer centre.

Midterm Results of the Salto Total Ankle Prosthesis

Clinical Orthopaedics and Related Research, 2004

The Salto Total Ankle Prosthesis is noncemented with mobile bearings and is characterized by an anatomic design and a dual Ti-HA coating. Between 1997 and 2000, 98 consecutive Salto prostheses were implanted. At last followup, two patients were deceased, one patient was lost to followup, and two prostheses were removed in two patients. Ninety-three implants in 91 patients were available with a mean followup of 35 months (range, 24-68 months). Survivorship at 68 months, with the end point implant removal, then was 98% (favorable scenario) to 94.9% (unfavorable scenario). The American Orthopaedic Foot and Ankle Society score was 32.3 points preoperatively and 83.1 points at followup. Seventy-two patients are pain-free, 54 patients walk unlimited distances, and 25 patients have limitation but walk more than 1 km. Sixty-seven patients have no limp but seven need walking aids. Fifty-eight patients can walk on tiptoes, 49 patients can walk on uneven ground, 14 patients can run, 76 patients ascend stairs normally, and 63 patients descend stairs normally. Range of motion as measured on stress radiographs improved from 15.2°preoperatively to 28.3°at followup. Preliminary results of the Salto prosthesis are encouraging and validate the concept of anatomic replacement.

Total Ankle Arthroplasty Survival and Risk Factors for Failure

Foot & Ankle International, 2019

Background: Total ankle arthroplasty (TAA) is an increasingly selected treatment for end-stage ankle arthritis; however, failure and revision of the tibial and talar components remains an issue. Although multiple risk factors have been shown to contribute to early component revision, no study has looked at combining such risk factors into a predictive model that could potentially decrease revision rates and improve implant survival. This study aimed to develop a predictive model for TAA failure based on patient characteristics, patient-reported outcomes (PROs), and immediate postoperative radiographs. Methods: A retrospective review of a single-site ankle arthritis database was conducted. All patients with current-generation ankle replacements including the Hintegra and Infinity prostheses implanted between 2004 and 2015 and with complete postoperative radiographs taken between 6 and 12 weeks postoperatively were included. Eight coronal and sagittal radiographic parameters were asse...

A Prospective Study of Four Total Ankle Arthroplasty Implants by Non-Designer Investigators

The Journal of bone and joint surgery. American volume, 2017

There are several types of prostheses available to surgeons when performing a total ankle arthroplasty (TAA). The main objective of this study was to summarize the clinical and functional outcomes of 4 TAA prostheses: the Hintegra implant (Integra LifeSciences), the Agility implant (DePuy), the Mobility implant (DePuy), and the Scandinavian Total Ankle Replacement (STAR) implant (Small Bone Innovations [SBi]). Patients were prospectively recruited. A total of 451 TAAs with a mean follow-up (and standard deviation) of 4.5 ± 2.0 years were included. Patients were assessed annually and completed self-reported outcome measures at these visits. Complications and revisions were reported at the time of incident. Mean improvements are reported by prosthesis. Linear mixed-effects models were used to obtain adjusted comparisons of scores across prostheses. Survivorship curves were generated by prosthesis and type of complication. Mean improvement in the Ankle Osteoarthritis Scale (AOS) total ...

Patient-Reported Outcomes Before and After Primary and Revision Total Ankle Arthroplasty

Foot & Ankle International, 2018

The number of total ankle replacements being performed each year continues to rise. 9 Better improvements in function and patient satisfaction, significant pain relief, and preserved hindfoot motion have led to this increase, while the rates of ankle arthrodesis remain steady. 9,26-28,33 This annual increase in primary total ankle arthroplasty (TAA) has also led to an increase in the rate of revision TAA. 7,20,36 The salvage procedures for failed total ankle replacement include revision with or without cementing the prosthesis, conversion to arthrodesis, cement arthroplasty, and amputation. 14,22,29 Not satisfied with the traditional treatments for failed TAA including arthrodesis, foot and ankle surgeons have sought and designed revision implants that simplify the handling of large bone voids and unstable joints. 6,25,27 Literature on outcomes of revision ankle arthroplasty surgery is sparse given the rates of revision TAA ranging from 8.4% to 17% reported in larger series with longer term follow-up. 8,10,11,23 The purpose of this investigation was to evaluate clinical results and improvements in patientreported outcomes (PROs) of a cohort of patients who underwent primary TAA and subsequently required revision TAA and had both primary and revision TAA at the host institution. Methods This institutional review board (IRB)-approved, retrospective chart review of prospectively collected data was conducted reviewing all patients who underwent primary 794956F AIXXX10.

Total ankle replacement. Review and critical analysis of the current status

Foot and Ankle Surgery, 1996

Therapy resistant ankle pain and the disadvantages of ankle arthrodesis lead to the development of numerous ankle joint prostheses. When considering all ankle joint endoprosthetic developments since 1970, two different kinds of prosthesis can be distinguished. (i) Two component prostheses which can be further classified as constrained, semiconstrained and nonconstrained and (ii) three component prostheses with a free gliding core (multiaxial systems). After encouraging short term results in the 1970s and early 1980s, disappointing long term results led to disuse of most of the previously developed prostheses. The two most frequent complications were aseptic loosening and wound healing. Aseptic loosening can result from large bone resection (tibial 8-16 mm and talar ca 7 mm) which lead to a fixation of soft cancellous bone which is not able to resist the forces acting on the anchoring systems. Besides bone resection, the geometry of an ankle joint replacement also plays an important part in aseptic loosening. This is clearly shown by the results from constrained design where the highest loosening rates occur in ankle joint prosthesis. The nonconstrained systems and multiaxial systems with free gliding core both showed lower loosening rates, but because of an unphysiologically large range of motion they are associated with stability problems. Constrained designs neglect the anatomical and biomechanical characteristics of the ankle joint leading to an unphysiological unidimensional range of motion as, regarding the anatomy and biomechanics of the ankle joint, it is evident that the ankle joint is not a real hinge joint. The curvatures of the talus and the tibial surfaces show varying radii. The radii of the talus are described as counter-rotating spiral radii and the tibial as a unform radius. These anatomical characteristics allow axial vertical rotation in the ankle joint as well as extension and flexion. In future, the incorporation of more anatomical characteristics should be taken into account when designing a new ankle joint replacement, in particular the counterrotating spiral radii of the talus. As well as incorporating anatomical curvatures into the design of an ankle joint system it is also necessary to reduce the bone resections to achieve lower loosening rates and thus better results.