title: Poor prosthesis survival and function after component exchange of total ankle prostheses.
abstract: OBJECTIVE
  In failed total ankle replacements (TARs), fusion is often the procedure of preference; the outcome after exchanging prosthetic components is debated. We analyzed prosthetic survival, self-reported function, and patient satisfaction after component exchange. Patients and methods We identified patients in the Swedish Ankle Registry who underwent exchange of a tibial and/or talar component between January 1, 1993 and July 1, 2013 and estimated prosthetic survival by Kaplan-Meier analysis. We evaluated the patient-reported outcome measures (PROMs) SEFAS, EQ-5D, EQ-VAS, SF-36, and patient satisfaction by direct questions.
  
  
  RESULTS
  69 patients underwent revision TAR median 22 (0-110) months after the primary procedure. 24 of these failed again after median 26 (1-110) months. Survival analysis of revision TAR showed a 5-year survival rate of 76% and a 10-year survival of 55%. 29 patients with first revision TAR in situ answered the PROMs at mean 8 (1-17) years after revision and had the following mean scores: SEFAS 22, SF-36 physical 37 and mental 49, EQ-5D index 0.6, and EQ-VAS 64. 15 of the patients were satisfied, 5 were neither satisfied nor dissatisfied, and 9 were dissatisfied.
  
  
  CONCLUSIONS
  Revision TAR had a 10-year survival of 55%, which is lower than the 10-year survival of 74% for primary TAR reported from the same registry. Only half of the patients were satisfied. Future studies should show which, if any, patients benefit from revision TAR and which patients should rather be fused directly.
authors: Departments of Orthopedics and Clinical Sciences , Lund University and Skåne University Hospital , Malmö ;
authors: Ilka
authors: I
authors: Kamrad
authors: Anders
authors: A
authors: Henricsson
authors: Magnus K
authors: MK
authors: Karlsson
authors: Håkan
authors: H
authors: Magnusson
authors: Jan-Åke
authors: JÅ
authors: Nilsson
authors: Åke
authors: Å
authors: Carlsson
authors: Björn E
authors: BE
authors: Rosengren
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D058737:Arthroplasty, Replacement, Ankle / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011379:Prognosis; D012042:Registries; D012086:Reoperation; D012189:Retrospective Studies; D013548:Sweden; D013628:Talus / Q000601:surgery*; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome