title: 10-year survival of total ankle arthroplasties: a report on 780 cases from the Swedish Ankle Register.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Orthopedics , Falun Central Hospital and Center for Clinical Research Dalarna, Falun, Sweden. anders.henricson@ltdalarna.se
authors: Anders
authors: A
authors: Henricson
authors: Jan-Åke
authors: JÅ
authors: Nilsson
authors: Ake
authors: A
authors: Carlsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058737:Arthroplasty, Replacement, Ankle / Q000009:adverse effects / Q000379:methods; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden; D055815:Young Adult