12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center

Authors

  • Mina Jane Zafar Department of Orthopedic Surgery, Hvidovre University Hospital, Denmark; Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Thomas Kallemose Clinical Orthopedic Research Centre, Hvidovre Hospital, Copenhagen University Hospital, Denmark
  • Mostafa Benyahia Department of Orthopedic Surgery, Hvidovre University Hospital, Denmark
  • Lars Bo Ebskov Department of Orthopedic Surgery, Hvidovre University Hospital, Denmark
  • Jeannette Østergaard Penny Department of Orthopedic Surgery, Hvidovre University Hospital, Denmark; Department of Orthopedic Surgery. University Hospital Zealand, Koege, Denmark

DOI:

https://doi.org/10.1080/17453674.2020.1751499

Abstract

Background and purpose — Total ankle arthroplasties (TAAs) have larger revision rates than hip and knee implants. We examined the survival rates of our primary TAAs, and what different factors, including the cause of arthritis, affect the success and/or revision rate.

Patients and methods — From 2004 to 2016, 322 primary Hintegra TAAs were implanted: the 2nd generation implant from 2004 until mid-2007 and the 3rd generation from late 2007 to 2016. A Cox proportional hazards model evaluated sex, age, primary diagnosis, and implant generation, pre- and postoperative angles and implant position as risk factors for revision.

Results — 60 implants (19%) were revised, the majority (n = 34) due to loosening. The 5-year survival rate (95% CI) was 75% (69–82) and the 10-year survival rate was 68% (60–77). There was a reduced risk of revision, per degree of increased postoperative medial distal tibial angle at 0.84 (0.72–0.98) and preoperative talus angle at 0.95 (0.90–1.00), indicating that varus ankles may have a larger revision rate. Generation of implant, sex, primary diagnosis, and most pre- and postoperative radiological angles did not statistically affect revision risk.

Interpretation — Our revision rates are slightly above registry rates and well above those of the developer. Most were revised due to loosening; no difference was demonstrated with the 2 generations of implant used. Learning curve and a low threshold for revision could explain the high revision rate.

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Published

2020-04-14

How to Cite

Zafar, M. J. ., Kallemose, T., Benyahia, M., Ebskov, L. B., & Penny, J. Østergaard. (2020). 12-year survival analysis of 322 Hintegra total ankle arthroplasties from an independent center. Acta Orthopaedica, 91(4), 444–449. https://doi.org/10.1080/17453674.2020.1751499