Complications after total ankle arthroplasty- A systematic review

Foot Ankle Surg. 2023 Jan;29(1):32-38. doi: 10.1016/j.fas.2022.09.010. Epub 2022 Sep 30.

Abstract

Background: Total ankle arthroplasty was developed as an alternative option to ankle arthrodesis in patients with end-stage ankle osteoarthritis. Multiple trials have assessed the outcomes of ankle arthroplasty, but complication risk or relative effectiveness is not systematized in literature.

Aim: Review complications of new designs of total ankle arthroplasty and the relationship between their severity and failure rates.

Methods: We reviewed complications and revision rates of prospective studies of primary total ankle arthroplasty that included more than 50 patients and with minimum 2 years follow-up.

Results: We included 22 studies (4412 ankles, median age of 61.9 years) with an adjusted mean follow-up time of 66.6 ± 40.9 months. The adjusted mean complication rate was 23.7 % (2.4-52 %), mostly high-grade complications (35.6 %). We found a statistically significant positive correlation between high- and medium-grade complications and revision rates.

Conclusion: Patient selection is crucial to successfully treat end-stage ankle osteoarthritis. Further multicenter clinical trials with consistent reporting of complications are warranted.

Keywords: Ankle; Arthroplasty; Postoperative Complications; Replacement.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Ankle Joint / surgery
  • Arthroplasty, Replacement, Ankle* / adverse effects
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Osteoarthritis* / surgery
  • Postoperative Complications* / epidemiology
  • Prospective Studies
  • Reoperation / statistics & numerical data
  • Treatment Outcome