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The outcomes of revision surgery for a failed ankle arthroplasty

Jennison, T; Spolton-Dean, C; Rottenburg, H; Ukoumunne, O; Sharpe, I; Goldberg, A; (2022) The outcomes of revision surgery for a failed ankle arthroplasty. Bone and Joint Open , 3 (7) pp. 596-606. 10.1302/2633-1462.37.BJO-2022-0038.R1. Green open access

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Abstract

Aims Revision rates for ankle arthroplasties are higher than hip or knee arthroplasties. When a total ankle arthroplasty (TAA) fails, it can either undergo revision to another ankle replacement, revision of the TAA to ankle arthrodesis (fusion), or amputation. Currently there is a paucity of literature on the outcomes of these revisions. The aim of this meta-analysis is to assess the outcomes of revision TAA with respect to surgery type, functional outcomes, and reoperations. Methods A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Medline, Embase, Cinahl, and Cochrane reviews were searched for relevant papers. Papers analyzing surgical treatment for failed ankle arthroplasties were included. All papers were reviewed by two authors. Overall, 34 papers met the inclusion criteria. A meta-analysis of proportions was performed. Results Six papers analyzed all-cause reoperations of revision ankle arthroplasties, and 14 papers analyzed failures of conversion of a TAA to fusion. It was found that 26.9% (95% confidence interval (CI) 15.4% to 40.1%) of revision ankle arthroplasties required further surgical intervention and 13.0% (95% CI 4.9% to 23.4%) of conversion to fusions; 14.4% (95% CI 8.4% to 21.4%) of revision ankle arthroplasties failed and 8% (95% CI 4% to 13%) of conversion to fusions failed. Conclusion Revision of primary TAA can be an effective procedure with improved functional outcomes, but has considerable risks of failure and reoperation, especially in those with periprosthetic joint infection. In those who undergo conversion of TAA to fusion, there are high rates of nonunion. Further comparative studies are required to compare both operative techniques

Type: Article
Title: The outcomes of revision surgery for a failed ankle arthroplasty
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1302/2633-1462.37.BJO-2022-0038.R1
Publisher version: http://dx.doi.org/10.1302/2633-1462.37.BJO-2022-00...
Language: English
Additional information: © 2022 Author(s) et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/ by-nc-nd/4.0/
Keywords: Ankle arthrodesis, Ankle replacement, Functional outcomes, Revision ankle replacement, amputations, ankle arthroplasties, nonunion, periprosthetic joint infection, primary total ankle arthroplasty, revision surgery, revision total ankle arthroplasty, surgical treatment, total ankle arthroplasty (TAA)
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10159755
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