Outcomes of revision surgery for failed total ankle replacement: revision arthroplasty versus arthrodesis

Purpose To compare the short-term outcomes of surgical management of failed ankle arthroplasty with revision ankle arthroplasty and conversion to arthrodesis. Methods Single-centre retrospective review of revision procedures for failed ankle arthroplasty between January 2012 and June 2019. Implant s...

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Bibliographic Details
Published in:International orthopaedics 2020-12, Vol.44 (12), p.2727-2734
Main Authors: Egglestone, Anthony, Kakwani, Rajesh, Aradhyula, Murty, Kingman, Angela, Townshend, David
Format: Article
Language:English
Subjects:
Ankle Joint - diagnostic imaging
Ankle Joint - surgery
Arthrodesis - adverse effects
Arthroplasty, Replacement, Ankle - adverse effects
Humans
Medicine
Medicine & Public Health
Original Paper
Orthopedics
Reoperation
Retrospective Studies
Treatment Outcome
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Summary:Purpose To compare the short-term outcomes of surgical management of failed ankle arthroplasty with revision ankle arthroplasty and conversion to arthrodesis. Methods Single-centre retrospective review of revision procedures for failed ankle arthroplasty between January 2012 and June 2019. Implant survival, union rates, and PROMS data—Pain Visual Analogue Score (VAS), Ankle Osteoarthritis Score (AOS) and Manchester-Oxford Foot Questionnaire (MOxFQ)—were compared between the two groups. Results Twenty-nine patients (31 ankles) underwent surgical management for failed ankle arthroplasty, with either revision arthroplasty ( n  = 21) or arthrodesis ( n  = 10). Revision arthroplasty had 87% survival at four years. Arthrodesis had an overall union rate of 80%. Two-year PROMS showed greater results for the revision arthroplasty group compared with that for arthrodesis group (Pain VAS 10 vs 50, p  = 0.03; total AOS 12 vs 87, p  = 0.04; average MOxFQ 17 vs 73.5, p 0.02). Conclusion Revision arthroplasty demonstrates good short-term survival data with improvements in PROMS compared with arthrodesis. Further long-term follow-up is required to monitor if these benefits continue.
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-020-04784-7