title: Long-term follow-up of mobile-bearing total ankle replacement in patients with inflammatory joint disease.
abstract: Little is known about the long-term outcome of mobile-bearing total ankle replacement (TAR) in the treatment of end-stage arthritis of the ankle, and in particular for patients with inflammatory joint disease. The aim of this study was to assess the minimum ten-year outcome of TAR in this group of patients. We prospectively followed 76 patients (93 TARs) who underwent surgery between 1988 and 1999. No patients were lost to follow-up. At latest follow-up at a mean of 14.8 years (10.7 to 22.8), 30 patients (39 TARs) had died and the original TAR remained in situ in 28 patients (31 TARs). The cumulative incidence of failure at 15 years was 20% (95% confidence interval (CI) 11 to 28). The mean American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score of the surviving patients at latest follow-up was 80.4 (95% CI 72 to 88). In total, 21 patients (23 TARs) underwent subsequent surgery: three implant exchanges, three bearing exchanges and 17 arthrodeses. Neither design of TAR described in this study, the LCS and the Buechel-Pappas, remains currently available. However, based both on this study and on other reports, we believe that TAR using current mobile-bearing designs for patients with end-stage arthritis of the ankle due to inflammatory joint disease remains justified.
authors.affiliation: Slotervaart Hospital, P.O. Box 90440, 1006 BK Amsterdam, the Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Kraal
authors.forename: H J L
authors.initials: HJ
authors.lastname: van der Heide
authors.forename: B J
authors.initials: BJ
authors.lastname: van Poppel
authors.forename: M
authors.initials: M
authors.lastname: Fiocco
authors.forename: R G H H
authors.initials: RG
authors.lastname: Nelissen
authors.forename: H C
authors.initials: HC
authors.lastname: Doets
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods; D058737:Arthroplasty, Replacement, Ankle / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Ankle arthritis; Ankle arthroplasty; Inflammatory joint disease; Long-term survival; Mobile-bearing prosthesis; Rheumatoid arthritis