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7a results of the first 100 cases of a totally new designed total ankle arthroplasty with main focus on universal use in all kinds of deformity, balancing and increasing ROM
ESSKA Academy. Orthner E. Nov 8, 2019; 286365
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7a results of the first 100 cases of a totally new designed total ankle arthroplasty with main focus on universal use in all kinds of deformity, balancing and increasing ROM

AFAS Free Papers

Topic: Hindfoot Arthritis

Orthner E.1, Kynsburg A.2
1Fußzentrum, Wels, Austria, 2Landesklinikum,, Scheibbs, Austria

TAA is still in debate. After more than 40 years of TAA the fusion seems still to be an alternative. Big deformities, big malalignements and bad ROM is always mentioned as an absolute or relative contraindication for TAA
The 7a results of the first 100 cases of a totally new designed mobile bearing 3 component prosthesis will be presented, done by the same surgeon. During the time of the first 100 prosthesis, there were only 9 ankle fusions done, which means that there is 91 % coverage of all arthritic cases with a TAA (exclusion only in infected cases and avascular necrosis of more than 30% of the talus).
The cases were followed preop and after 3,6, 12, 24, 36, 48, 60, 72 month with X-ray, clinical examination, VAS score, AOFAS score, NAS score and AAA Score and measuring range of motion and after 12 month and 60 mo in addition with a CT - scan.
The mean age of the patients 60,3 a, 56 were male, 44 fem. Of the 100 cases 6 pt. died due to internal reasons. All 6 cases were followed to there death, at least 24 month or longer without a complication of the implant. Out of the remaining 94 all could be followed for at least 7a. Major revision (defined as exchange of one or more of the 3 components) was done in 7 cases, 1 due to infection, 3 avascular talusnecrosis, 1 instability, 2 loosening. These were true failures, only 2 directly related to the prosthesis.
The remaining 87 cases were evaluated acc. to the mentioned follow up criteria.
The AOFAS score improved from 29.1 peop, to 76,6 after 3 month and 88,2 after 6 month with no detoriation over time to the last follow up. The VAS score raised from 40,6 preop to 66,5 after 6 month and increasing continousely. The NAS Score improved as well significantly, as well as the AAA score.
The most significant improvement was for the ROM from 30° preop to 52° at the last follow up, which means an improvement of 74% - an improvement which till now never could be reached.
Depsite the fact that almost all cases of ankle arthritis were treated with a TAA independant from the amount of deformity, malalignement or loss of motion, the results at midterm follow up are better than most presented studies, the revision and complication rate low and the ROM superior to all published studies. The new concept is total balancing of the joint in combination with additional procedures and extensive medial malleolar osteotomy. The edge points of the operation technique will be presented as well as the results in detail.
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