Article

The first generations of total ankle replacements (TARs)
showed a high rate of early failure. In the last decades,
much progress has been
made in the development of TARs, with the newer generation showing better
results. We evaluated TARs implanted with rheumatoid arthritis (RA) or juvenile
inflammatory arthritis (JIA) as indication. PATIENTS AND METHODS: 58 total ankle
prostheses (Buechel-Pappas and STAR type) were implanted in patients with RA (n =
53) or JIA (n = 5) in 54 patients (4 bilateral). After a mean followup of 2.7
(1-9) years, all patients were reviewed by two orthopedic surgeons who were not
the surgeons who performed the operation. Standard AP and lateral radiographs
were taken and a Kofoed ankle score was obtained; this is a clinical score
ranging from 0-100 and consists of sub-scores for pain, disability, and range of
motion. RESULTS: 2 patients died of unrelated causes. Of the 52 patients who were
alive (56 prostheses), 51 implants were still in place and showed no signs of
loosening on the most recent radiographs. The mean Kofoed score at follow-up was
73 points (SD 16, range 21-92). 4 patients showed a poor result (score < 50) with
persistent pain for which no obvious reason could be found.
5 implants were
removed, 4 because of infection and 1 because of aseptic loosening.
INTERPRETATION: Medium-term results of the STAR and BP types of TAR in RA were
satisfactory. The main reason for failure of the implant was infection.

Langue : ANGLAIS