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Early Prospective Clinical Results of a Modern Fixed-Bearing Total Ankle Arthroplasty
Karl M. Schweitzer, MD1; Samuel B. Adams, MD2; Nicholas A. Viens, MD3; Robin M. Queen, PhD4; Mark E. Easley, MD2; James K. DeOrio, MD2; James A. Nunley, MD2
1 Department of Orthopaedic Surgery, Duke University Medical Center, Box 3000, Durham, NC 27710. E-mail address: karl.schweitzer@duke.edu.
2 Department of Orthopaedic Surgery, Duke University Medical Center, Duke Medical Plaza, 4709 Creekstone Drive, Suite 200, Durham, NC 27703. E-mail address for S.B. Adams Jr.: samuel.adams@duke.edu. E-mail address for M.E. Easley: mark.e.easley@duke.edu. E-mail address for J.K. DeOrio: james.deorio@duke.edu. E-mail address for J.A. Nunley II: james.nunley@duke.edu.
3 The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO 81657. E-mail address: viens001@notes.duke.edu.
4 Department of Orthopaedic Surgery, Duke University Medical Center, 102 Finch Yeager Building, DUMC 3435, Durham, NC 27710. E-mail address for R.M. Queen: robin.queen@duke.edu.
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  • Disclosure statement for author(s): PDF

Investigation performed at the Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina

Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Jun 05;95(11):1002-1011. doi: 10.2106/JBJS.L.00555
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Several fixed-bearing total ankle arthroplasty systems are available in the United States. We report on the early clinical results of the largest known cohort of patients in the United States who received a Salto Talaris total ankle replacement for the treatment of end-stage arthritis of the ankle.


We prospectively followed sixty-seven patients with a minimum clinical follow-up of two years. Patients completed standardized assessments and underwent physical examination, functional assessment, and radiographic evaluation preoperatively and at six weeks, three months, and six months postoperatively and yearly thereafter through their most recent follow-up.


Implant survival at a mean follow-up time of 2.8 years was 96% when metallic component revision, removal, or impending failure was used as the end point. Three patients developed aseptic loosening, and all instances involved the tibial component. One of the three patients underwent revision to another fixed-bearing total ankle arthroplasty system, one patient is awaiting revision surgery, and the third patient has remained minimally symptomatic and fully functional without additional surgery. Forty-five patients underwent at least one additional procedure at the time of the index surgery. The most common concurrent procedure performed was a deltoid ligament release (n = 21). Eight patients underwent additional surgery following the index arthroplasty, most commonly debridement for medial and/or lateral impingement (n = 4). As of the most recent follow-up, patients demonstrated significant improvement in pain scores, American Orthopaedic Foot & Ankle Society hindfoot score, and functional scores.


Early clinical results indicate that the Salto Talaris fixed-bearing total ankle arthroplasty system can provide significant improvement in pain, quality of life, and standard functional measures in patients with end-stage ankle arthritis.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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