Article

A report on 780 cases from the Swedish Ankle Register. There is an ongoing need to review large series of total
ankle replacements (TARs) for monitoring of changes in practice and their
outcome. 4 national registries, including the Swedish Ankle Register, have
previously reported their 5-year results. We now present an extended series with
a longer follow-up, and with a 10-year survival analysis. METHODS:
Records of uncemented 3-component TARs were retrospectively reviewed, determining
risk factors such as age, sex, and diagnosis. Prosthetic survival rates were
calculated with exchange or removal of components as endpoint-excluding
incidental exchange of the polyethylene meniscus. RESULTS: Of the 780 prostheses
implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall
survival rate fell from 0.81 (95% CI: 0.79-0.83) at 5 years to 0.69 (95% CI:
0.67-0.71) at 10 years. The survival rate was higher, although not statistically
significantly so, during the latter part of the period investigated. Excluding
the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at
10 years. Women below the age of 60 with osteoarthritis were at a higher risk of
revision, but age did not influence the outcome in men or women with rheumatoid
arthritis. Revisions due to technical mistakes at the index surgery and
instability were undertaken earlier than revisions for other reasons.
INTERPRETATION: The results have slowly improved during the 18-year period
investigated. However, we do not believe that the survival rates of ankle
replacements in the near future will approach those of hip and knee
replacements-even though improved instrumentation and design of the prostheses,
together with better patient selection, will presumably give better results.

Langue : ANGLAIS