title: Early prospective clinical results of a modern fixed-bearing total ankle arthroplasty.
abstract: BACKGROUND
  Several fixed-bearing total ankle arthroplasty systems are available in the United States. We report on the early clinical results of the largest known cohort of patients in the United States who received a Salto Talaris total ankle replacement for the treatment of end-stage arthritis of the ankle.
  
  
  METHODS
  We prospectively followed sixty-seven patients with a minimum clinical follow-up of two years. Patients completed standardized assessments and underwent physical examination, functional assessment, and radiographic evaluation preoperatively and at six weeks, three months, and six months postoperatively and yearly thereafter through their most recent follow-up.
  
  
  RESULTS
  Implant survival at a mean follow-up time of 2.8 years was 96% when metallic component revision, removal, or impending failure was used as the end point. Three patients developed aseptic loosening, and all instances involved the tibial component. One of the three patients underwent revision to another fixed-bearing total ankle arthroplasty system, one patient is awaiting revision surgery, and the third patient has remained minimally symptomatic and fully functional without additional surgery. Forty-five patients underwent at least one additional procedure at the time of the index surgery. The most common concurrent procedure performed was a deltoid ligament release (n = 21). Eight patients underwent additional surgery following the index arthroplasty, most commonly debridement for medial and/or lateral impingement (n = 4). As of the most recent follow-up, patients demonstrated significant improvement in pain scores, American Orthopaedic Foot & Ankle Society hindfoot score, and functional scores.
  
  
  CONCLUSIONS
  Early clinical results indicate that the Salto Talaris fixed-bearing total ankle arthroplasty system can provide significant improvement in pain, quality of life, and standard functional measures in patients with end-stage ankle arthritis.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Box 3000, Durham, NC 27710, USA. karl.schweitzer@duke.edu
authors.forename: Karl M
authors.initials: KM
authors.lastname: Schweitzer
authors.forename: Samuel B
authors.initials: SB
authors.lastname: Adams
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Viens
authors.forename: Robin M
authors.initials: RM
authors.lastname: Queen
authors.forename: Mark E
authors.initials: ME
authors.lastname: Easley
authors.forename: James K
authors.initials: JK
authors.lastname: Deorio
authors.forename: James A
authors.initials: JA
authors.lastname: Nunley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001168:Arthritis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D058737:Arthroplasty, Replacement, Ankle / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States