title: Effect of Age on Outcomes in Total Ankle Arthroplasty.
abstract: BACKGROUND
  Little is known about the efficacy and durability of total ankle arthroplasty (TAA) in younger patients. The purpose of this study was to determine the effect of age on the clinical, radiographic, and patient-reported outcomes of patients with end-stage ankle arthritis treated with TAA using modern prostheses.
  
  
  METHODS
  Patients who underwent primary TAA from June 2007 to July 2011 were prospectively enrolled in the study. Three hundred and ninety-five consecutive patients were reviewed with a mean follow-up of 3.5 years (range, 2-5.4 years). Patients were divided into 3 groups based on age at the time of surgery (<55, 55-70, and >70 years). Patient-reported outcome scores, physical performance scores, and weight-bearing radiographs were used to assess patients preoperatively and at yearly postoperative office visits. Revision was defined as failure of either the tibial or talar components requiring removal of the metallic implants. A repeated-measures analysis of variance with post hoc testing and the Pearson chi-square test were used to assess differences between the 3 groups. Statistical significance was set at an alpha level of .05.
  
  
  RESULTS
  Patients under the age of 55 had a greater improvement in Short-Form 36 (SF-36) Vitality (P = .026) and American Orthopaedic Foot & Ankle Society (AOFAS) Function scores (P < .001) compared with patients over the age of 70 at most recent follow-up. There were no differences in the Visual Analog Scale (VAS) pain score or the physical performance outcomes between the age groups. The incidence of wound complications, need for reoperation, and revision were not different between groups.
  
  
  CONCLUSIONS
  Outcomes of TAA in younger patients were similar to outcomes in older patients at early follow-up. This study establishes a cohort of patients that will be followed to determine the effect of age on the long-term outcomes of TAA with an emphasis on the need for reoperation and revision.
  
  
  METHODS
  Level II, prospective comparative study.
authors: Hospital for Special Surgery, New York, NY, USA demetracopoulos.md@gmail.com.
authors: Constantine A
authors: CA
authors: Demetracopoulos
authors: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
authors: Samuel B
authors: SB
authors: Adams
authors: Michael W. Krzyzewski Human Performance Laboratory, Duke University Medical Center, Durham, NC, USA.
authors: Robin M
authors: RM
authors: Queen
authors: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
authors: James K
authors: JK
authors: DeOrio
authors: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
authors: James A
authors: JA
authors: Nunley
authors: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
authors: Mark E
authors: ME
authors: Easley
mesh_terms: D000367:Age Factors; D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D001168:Arthritis / Q000601:surgery*; D058737:Arthroplasty, Replacement, Ankle; D006801:Humans; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011183:Postoperative Complications; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012086:Reoperation; D064232:Visual Analog Scale
keywords: age; ankle arthritis; total ankle arthroplasty; total ankle replacement