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Risk Factors for Failure of Total Ankle Arthroplasty With a Minimum Five Years of Follow-up.

Publication ,  Journal Article
Cody, EA; Bejarano-Pineda, L; Lachman, JR; Taylor, MA; Gausden, EB; DeOrio, JK; Easley, ME; Nunley, JA
Published in: Foot Ankle Int
March 2019

BACKGROUND:: As the popularity of total ankle arthroplasty (TAA) increases and indications expand, surgeons require a better understanding of which patient factors are associated with implant failure. In this study, we aimed to use a large total ankle database to identify independent risk factors for implant failure at mid- to long-term follow-up. METHODS:: A prospectively collected database was used to identify all patients who underwent primary TAA with a minimum 5 years' follow-up. The primary outcome was revision, defined as removal of one or both metal components; failures due to infection were excluded. Patient and clinical factors analyzed included age, sex, body mass index (BMI), smoking status, presence of diabetes, indication for TAA, implant, tourniquet time, and presence of ipsilateral hindfoot fusion. Preoperative coronal deformity and sagittal talar translation were assessed, as were postoperative coronal and sagittal tibial component alignment. Univariable and multivariable analyses were performed to identify predictors of implant failure. After excluding 5 ankles that failed because of deep infection, 533 ankles with a mean 7 (range, 5-11) years of follow-up met the inclusion criteria. Four implants were used: INBONE I, INBONE II, STAR, and Salto-Talaris. RESULTS:: Thirty-four ankles (6.4%) were revised or removed a mean 4 (range, 1-9) years postoperatively. The only independent predictors of failure were the INBONE I prosthesis and ipsilateral hindfoot fusion ( P = .006 and P = .023, respectively). CONCLUSIONS:: This is among the largest studies to analyze the relationship between TAA failure rates and multiple different patient, operative, and radiographic factors. Of note, age, BMI, and amount of deformity were not associated with higher failure rates. Only patients with ipsilateral hindfoot fusion or who received the INBONE I prosthesis were at significantly higher risk of implant failure. LEVEL OF EVIDENCE:: Level III, retrospective cohort study.

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Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

March 2019

Volume

40

Issue

3

Start / End Page

249 / 258

Location

United States

Related Subject Headings

  • Time Factors
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Radiography
  • Prosthesis Failure
  • Prosthesis Design
  • Orthopedics
  • Middle Aged
  • Male
 

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Cody, E. A., Bejarano-Pineda, L., Lachman, J. R., Taylor, M. A., Gausden, E. B., DeOrio, J. K., … Nunley, J. A. (2019). Risk Factors for Failure of Total Ankle Arthroplasty With a Minimum Five Years of Follow-up. Foot Ankle Int, 40(3), 249–258. https://doi.org/10.1177/1071100718806474
Cody, Elizabeth A., Lorena Bejarano-Pineda, James R. Lachman, Michel A. Taylor, Elizabeth B. Gausden, James K. DeOrio, Mark E. Easley, and James A. Nunley. “Risk Factors for Failure of Total Ankle Arthroplasty With a Minimum Five Years of Follow-up.Foot Ankle Int 40, no. 3 (March 2019): 249–58. https://doi.org/10.1177/1071100718806474.
Cody EA, Bejarano-Pineda L, Lachman JR, Taylor MA, Gausden EB, DeOrio JK, et al. Risk Factors for Failure of Total Ankle Arthroplasty With a Minimum Five Years of Follow-up. Foot Ankle Int. 2019 Mar;40(3):249–58.
Cody, Elizabeth A., et al. “Risk Factors for Failure of Total Ankle Arthroplasty With a Minimum Five Years of Follow-up.Foot Ankle Int, vol. 40, no. 3, Mar. 2019, pp. 249–58. Pubmed, doi:10.1177/1071100718806474.
Cody EA, Bejarano-Pineda L, Lachman JR, Taylor MA, Gausden EB, DeOrio JK, Easley ME, Nunley JA. Risk Factors for Failure of Total Ankle Arthroplasty With a Minimum Five Years of Follow-up. Foot Ankle Int. 2019 Mar;40(3):249–258.
Journal cover image

Published In

Foot Ankle Int

DOI

EISSN

1944-7876

Publication Date

March 2019

Volume

40

Issue

3

Start / End Page

249 / 258

Location

United States

Related Subject Headings

  • Time Factors
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Radiography
  • Prosthesis Failure
  • Prosthesis Design
  • Orthopedics
  • Middle Aged
  • Male