American orthopaedic foot and ankle society (2018) published "single-surgeon experience and complications of a fixed-bearing total ankle arthroplasty".This study aimed to retrospectively evaluate intra- and postoperative complications in 96 patients (104 total ankle arthroplasty) from a consecutive, single-surgeon population of primary salto talaris arthroplasty procedures, using radiographic analysis and medical records review to identify complications and the glazebrook classification system to categorize complications.Method: medical records from index procedure to latest follow-up of primary taa were reviewed.Complications were categorized according to the glazebrook classification; additional complications were documented.Concurrent procedures were recorded, and radiographs were analyzed for alignment, subsidence, and cyst formation.Time to complication onset and learning curve analyses were performed.One hundred four salto talaris taa prostheses (96 patients), with an average follow-up of 46 months, were included.Results: thirty-five complications were identified in 32 ankles with a 34% complication rate, resulting in 11 reoperations (5 taa revisions).Technical error (n = 12), wound healing (n = 9), and aseptic loosening (n = 4) were the most common complications, and there were no statistically significant differences in demographics or follow-up duration between cases with versus without complications.In both the cohorts with and without complications, there were moderate, negative correlations between radiographically observed keel osteopenia and lucency; also, in the complication cohort, a weak, positive correlation between subsidence and lucency was found.Conclusion: the 2-component salto talaris taa was an existing tool for the management of advanced ankle arthritis in a range of potential ankle arthroplasty candidates; however, few clinical reports and analyses of this specific implant existed.Two learning curve analyses highlighted the significance of technical expertise and annual volume of taa cases on complication rates.Implant survivorship and reoperation rate in this series were similar to previously reported early-term outcomes.The glazebrook classification of complication types in taa was applied to this series.A statistically significant correlation was found between radiographically observed lucency and "keel osteopenia" in both the cohorts, with and without complications.It may be possible to identify patients who are at increased risk for impending taa failure by documenting radiographic periprosthetic lucency, osteolysis, and cyst formation, thus allowing the clinician opportunities for more vigilant observation and follow-up.Event description for subject# 71: patient's age and gender - (b)(6) female, (b)(6), preoperative diagnosis - [left] rheumatoid arthritis, osteopenia, medical history - osteoporosis, rheumatoid arthritis, gerd, hemochromatosis, operative history - bilateral total hip arthroplasty, right knee arthroscopic surgery, concomitant procedure - tendo-achilles lengthening; talonavicular fusion; open reduction and internal fixation medial and lateral malleoli, total follow-up (months) - 38, complication type - nonunion, complication onset (months) - 3, complication details - migration of talonavicular hardware, with nonunion, complication treatment - total ankle arthroplasty revision, complication rating - high.
|