title: High revision and reoperation rates using the Agility™ Total Ankle System.
abstract: BACKGROUND
  Total ankle arthroplasty (TAA) is an evolving treatment for end-stage ankle arthritis, however, there is controversy regarding its longevity.
  
  
  OBJECTIVE
  We determined survival of the Agility™ TAA, the overall reoperation rate, and function in patients who retained their implant.
  
  
  METHODS
  We retrospectively reviewed 64 patients who had 65 TAAs between June 1999 and May 2001. Information was gathered through chart reviews, mailed-in questionnaires, and telephone interviews. Nine patients had died; data were available for 41 of the remaining 55 patients. Survival was based on revision as an end point. The minimum followup was 0.5 years (median, 8 years; range, 0.5-11 years).
  
  
  RESULTS
  Sixteen of the 41 patients (39%) needed revisions. The average time to revision surgery was 4 years with six of the revisions (38%) occurring within 1 year of the TAA. Of the 25 patients who retained their implants, 12 required secondary surgery for an overall reoperation rate of 28 of 41 (68%) at an average of 8 years followup. The average VAS pain score was 4, the average Foot and Ankle Ability Measure (FAAM) sports subscale score was 33, and the average FAAM activities of daily living subscale score was 57.
  
  
  CONCLUSIONS
  TAA had high revision and reoperation rates. Patients who retained their implant had only moderate pain relief and function. TAA must be approached with caution. More research is needed to elucidate the role of contemporary TAA.
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Braden J
authors.initials: BJ
authors.lastname: Criswell
authors.forename: Keith
authors.initials: K
authors.lastname: Douglas
authors.forename: Rishi
authors.initials: R
authors.lastname: Naik
authors.forename: A Brian
authors.initials: AB
authors.lastname: Thomson
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000503:physiopathology / Q000601:surgery*; D001168:Arthritis / Q000503:physiopathology / Q000601:surgery*; D019643:Arthroplasty, Replacement / Q000009:adverse effects / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D020878:Device Removal; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D011474:Prosthesis Design; D011475:Prosthesis Failure; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D013714:Tennessee; D013997:Time Factors; D055815:Young Adult