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Total Ankle Arthroplasty: a Unique Design. Two to Twelve-Year Follow-up*
MICHAEL T. PYEVICH, M.D.†; CHARLES L. SALTZMAN, M.D.†; JOHN J. CALLAGHAN, M.D.†, IOWA CITY, IOWA; FRANK G. ALVINE, M.D.‡, SIOUX FALLS, SOUTH DAKOTA
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Investigation performed at the Department of Orthopaedic Surgery, University of Iowa, Iowa City, and Orthopaedic Associates, Sioux Falls
J Bone Joint Surg Am, 1998 Oct 01;80(10):1410-20
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Abstract

We evaluated the intermediate-term results of a novel total ankle arthroplasty that includes insertion of the components without cement and arthrodesis of the tibiofibular syndesmosis as part of the operative procedure. One hundred consecutive Agility ankle replacements were performed in ninety-five patients between 1984 and 1993. At the time of follow-up, eighty-three patients (eighty-six ankles) were alive and twelve patients (fourteen ankles) had died. Five (6 per cent) of the eighty-six ankles in the living patients had been revised. Including the components that had been revised for loosening, twenty-one (twelve tibial and nine talar) components had migrated. Delayed union of the syndesmosis (twenty-eight ankles) and non-union of the syndesmosis (nine ankles) were associated with the development of lysis around the tibial component. Non-union of the syndesmosis was also associated with migration of the tibial component and circumferential radiolucency around that component.In addition to the patients who died, one patient had a resection of the implant with subsequent arthrodesis. The remaining eighty-two patients (eighty-five ankles) were the basis for the clinical evaluation in the study. The average age at the time of the procedure was sixty-three years (range, twenty-seven to eighty-one years). At the time of the most recent follow-up (range, 2.8 to 12.3 years; average, 4.8 years), forty-seven (55 per cent) of the remaining eighty-five ankles were not painful and twenty-four (28 per cent) were only mildly painful. The range of motion of the fifty-six ankles that were examined at the time of follow-up averaged 36 degrees (range, 10 to 64 degrees), and the results for seventy-nine (93 per cent) of the eighty-five ankles were satisfactory to the patients.

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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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