257 ankle arthroplasties performed in Norway between 1994 and 2005

University of Bergen, Bergen, Hordaland, Norway
Acta Orthopaedica (Impact Factor: 2.77). 11/2007; 78(5):575-83. DOI: 10.1080/17453670710014257
Source: PubMed


There have been few reports on the long-term outcome of ankle replacements. The Norwegian Arthroplasty Register has been registering ankle replacements since 1994, but no analysis of these data has been published to date. Here we report data on the use of total ankle replacements and the revision rate in the Norwegian population over a 12-year period.
We used the Norwegian Arthroplasty Register to find ankle arthroplasties performed between 1994 and 2005. Patient demographics, diagnoses, brands of prosthesis, revisions, and time trends were investigated.
There were 257 primary ankle replacements, 32 of which were cemented TPR prostheses and 212 of which were cementless STAR prostheses. The overall 5- year and 10-year survival was 89% and 76%, respectively. Prosthesis survival was the same for the cementless STAR prosthesis and the cemented TPR prosthesis. There was no significant influence of age, sex, type of prosthesis, diagnosis, or year of operation on the risk of revision. The incidence of ankle replacements due to osteoarthritis, but not due to inflammatory arthritis, increased over the years.
The revision rate was acceptable compared to other studies of ankle arthroplasties, but high compared to total knee and hip arthroplasties. The overall incidence of ankle replacements increased during the study period.

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    • "Even so, implant survival would be expected to decrease in the years to come. Even if the implant survival curve would decline after 9 years, the implant survival in our series is still comparable to the implant survival after total elbow arthroplasty and total ankle arthroplasty, which are more commonly used and less debatable procedures (Fevang et al. 2007, 2009, Skytta et al. 2009, 2010). "
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    ABSTRACT: Background and purpose During the past 40 years, several attempts have been made with total wrist arthroplasty to avoid fusion in severely destroyed wrists. The results have often been disappointing. There is only modest clinical documentation due to the small number of patients (especially non-rheumatoid cases) and short follow-up times. Here we report a multicenter series using a third-generation implant with a minimum follow-up time of 5 years. Methods In 2012, data were retrieved from a registry of consecutive wrist operations at 7 centers with units specialized in hand surgery, between 2003 and 2007. The wrists had been reviewed annually and analysis was done on the latest follow-up data. Results 60 patients had been operated (5 bilaterally), 5 wrists had been revised, and 52 were available for follow-up (with the revised cases excluded). The pain scores, QuickDASH scores, ulnar flexion, and supination for the whole group were statistically significantly better at follow-up. There were no statistically significant differences between the rheumatoid and the non-rheumatoid patients except for motion, which was better in the non-rheumatoid group. The motion obtained depended on the preoperative motion. Implant survival was 0.9 at 5–9 years. Interpretation The clinical results in terms of pain, motion, strength, and function were similar to those in previous reports. The implant survival was 0.9 at 9 years, both in rheumatoid and non-rheumatoid cases, which is an important improvement compared to the earlier generations of total wrist arthroplasty.
    Acta Orthopaedica 07/2013; 84(4). DOI:10.3109/17453674.2013.823588 · 2.77 Impact Factor
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    • "In the orthopaedic literature, there are very few studies that compare implants head to head that are either Level I or Level II, and the superiority of an implant design over another cannot be supported by any available data from Level IV studies [42]. The experiences of several national joint registries have been published previously [43–46]. No statistically significant risk factors (e.g., age, gender, type of prosthesis, underlying etiology) have been identified as influencing survivorship of prosthesis components in Norwegian Arthroplasty Register [43], Finnish Arthroplasty Register [46], and New Zealand National Joint Registry [45]. "
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    ABSTRACT: End-stage osteoarthritis of the ankle is a disabling problem, particularly in elderly patients who experience an overall loss of mobility and functional impairment and who then need compensatory adaption. Ankle arthrodesis, which has been demonstrated to provide postoperative pain relief and hindfoot stability, leaves the patient with a stiff foot and gait changes. For elderly patient, these changes may be more critical than generally believed. Additionally, the long duration of healing and rehabilitation process needed for ankle arthrodesis may be problematic in the elderly. In contrast to ankle arthrodesis, total ankle replacement has significant advantages including a less strenuous postoperative rehabilitation and preservation of ankle motion which supports physiological gait. Recently, total ankle replacement has evolved as a safe surgical treatment in patients with end-stage ankle osteoarthritis with reliable mid- to long-term results. Total ankle replacement needs less immobilization than arthrodesis and does allow for early weight-bearing and should be considered as a treatment option of first choice in many elderly patients with end-stage osteoarthritis of the ankle, especially in elderly patients with lower expectations and physical demands.
    Journal of aging research 06/2012; 2012(7):345237. DOI:10.1155/2012/345237
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    • "Total ankle replacement (TAR) is an established surgical procedure in patients with severe ankle osteoarthritis (Gougoulias et al. 2010), and is becoming an increasingly recommended treatment option instead of ankle arthrodesis (Saltzman et al. 2009). Several national arthroplasty registers have reported favorable medium-term results (Fevang et al. 2007, Henricson et al. 2007, Hosman et al. 2007, Skytta et al. 2010). "
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    ABSTRACT: Total ankle replacement is an established surgical procedure in patients with end-stage ankle osteoarthritis. We analyzed complications and medium-term results in patients with simultaneous bilateral total ankle replacement. 10 women and 16 men, mean age 60 (SD 13) years, were followed for a median of 5 (2-10) years. There were no intraoperative or perioperative complications, with the exception of 1 patient with prolonged wound healing. Major revision surgery was necessary in 6 of the 52 ankles, including 4 revisions of prosthetic components. The average pain score decreased from 6.9 (4-10) to 1.8 (0-4) points. The American Orthopaedic Foot and Ankle Society hindfoot score increased from 32 (SD 14) points preoperatively to 74 (SD 12) points postoperatively. The average range of motion increased from 28° (SD 12) preoperatively to 38° (SD 9) postoperatively. All 8 categories of SF-36 score improved. Simultaneous bilateral total ankle replacement is a suitable method for restoration of function and attainment of pain relief in patients with bilateral end-stage ankle osteoarthritis. The results of this procedure, including complication rates, revision rates, and functional outcome, are comparable to those reported in patients with unilateral total ankle replacement.
    Acta Orthopaedica 12/2011; 82(6):704-10. DOI:10.3109/17453674.2011.623570 · 2.77 Impact Factor
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