title: Effect of Coronal and Sagittal Alignment on Outcome After Mobile-Bearing Total Ankle Replacement.
abstract: BACKGROUND
  Comparably high revision rates are reported after total ankle replacement (TAR). Therefore, further critical analysis of the influence of implant position on clinical outcome is necessary.
  
  
  METHODS
  We analyzed the reliability and predictive value of previously published pre- and postoperative coronal and sagittal parameters in routine ankle radiographs on the clinical outcome of 84 HINTEGRA total ankle replacements (Newdeal, Lyon, France; Integra, Plainsboro, New Jersey). Mean follow-up was 4.0 years, and 15.5% of the TARs had revision surgery.
  
  
  RESULTS
  Mean postoperative American Orthopaedic Foot & Ankle Society ankle-hindfoot score was 71.3; mean postoperative verbal rating scale for pain was 3.1; and mean postoperative ankle range of motion was 26.4 degrees. Most tested radiologic parameters showed moderate or high intra- and interobserver reliability. With the numbers available, no significant difference in clinical outcome for all tested radiologic parameters could be detected.
  
  
  CONCLUSIONS
  Our results indicate that mild malalignment of TAR, as assessed on routine ankle radiographs, did not affect midterm clinical outcome after TAR. Further multicenter studies with longer follow-up are needed to support our findings.
  
  
  METHODS
  Level III, comparative series.
authors.affiliation: Department of Orthopaedics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Braito
authors.affiliation: Department of Orthopaedics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Dammerer
authors.affiliation: Department of Orthopaedics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Reinthaler
authors.affiliation: Department of Orthopaedics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kaufmann
authors.affiliation: Department of Experimental Orthopaedics, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Dennis
authors.initials: D
authors.lastname: Huber
authors.affiliation: Department of Orthopaedics, Innsbruck Medical University, Innsbruck, Austria rainer.biedermann@i-med.ac.at.
authors.forename: Rainer
authors.initials: R
authors.lastname: Biedermann
mesh_terms: D000843:Ankle Joint / Q000000981:diagnostic imaging*; D058737:Arthroplasty, Replacement, Ankle; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D063868:Patient Outcome Assessment; D011237:Predictive Value of Tests; D017755:Prosthesis Fitting; D011859:Radiography; D016059:Range of Motion, Articular; D015203:Reproducibility of Results
keywords: clinical outcome; implant position; radiologic analysis; total ankle replacement