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SURVIVORSHIP OF TOTAL ANKLE ARTHROPLASTY IN RHEUMATOID ARTHRITIS



Abstract

Between 1993 and 1999, 119 total ankle arthroplasties (TAA) in 106 patients were performed. The prosthetic design in all cases was the Scandinavian Total Ankle Replacement (STAR). All patients have been reviewed annually.

Eight arthroplasties have been revised (see table for reasons for revision).

Twenty-four TAA were satisfactory at last review (4–87 months) in 19 patients who died. Annual review continues for 87 TAA. When last seen the average follow up was 72 months (48–123). The cumulative survival for all 119 TAA is 92% (see figure below).

Comment The complication of recurrent deformity causing ‘edge loading’ of the insert and failure can hopefully be avoided by not attempting arthroplasty in patients with more than 20 degrees of pre-operative valgus. The problem of aseptic loosening is harder to understand. Subsidence may be avoided by more accurate shaping of the talus to give better bony integration but osteolysis behind a well-fixed component remains an unsolved problem with respect to both its cause and treatment.

Correspondence should be addressed to BOFSS, c/o Wrightington Wigan and Leigh NHS Trust, Hall Lane, Appley Bridge, Wigan, Lancashire WN7 9EP.