Results at a minimum follow-up of 5 years of a ligaments-compatible total ankle replacement design

Background: A new design of 3-part ankle replacement was developed to achieve compatibility with the natural ligaments by allowing certain fibers to remain isometric during passive motion. Methods: We evaluate 75 ankle prostheses implanted from July 2003 to December 2008, at a mean follow-up 6.5 +/- 1.1 years ( range 5-9 years). The mean age at surgery was 62 +/- 13 years ( range 29-82). Results: The mean AOFAS scores achieved at pre-op and at last follow-up were respectively 37 +/- 5 ( 23-45) and 78 +/- 8 ( 64-98). ( p < 0.001). Clinical range of motion of the ankle measured by goniometer pre op was 1 degrees +/- 2 of dorsiflexion and 12 degrees +/- 4 degrees of plantarflexion; at last follow- up range of motion increased to 6 degrees +/- 5 degrees in dorsiflexion ( p < 0.01) and 18 degrees +/- 7 degrees in plantarflexion ( p < 0.05). Radiographs showed no loosening and little signs of radiolucency. Two revisions necessitated component removal, neither for implant loosening. The overall survival rate was 97.3%. Conclusions: Function and Range-of-motion showed significant improvements. These results demonstrate that ligaments-compatible shaped talar and tibial components, with a fully conforming interposed meniscal bearing, can provide satisfactory survival rates and clinical outcomes in the middle term. (C) 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.