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Better implant survival with modern ankle prosthetic designs : 1,226 total ankle prostheses followed for up to 20 years in the Swedish Ankle Registry

Undén, Alexandra LU ; Jehpsson, Lars LU ; Kamrad, Ilka LU ; Carlsson, Åke LU ; Henricson, Anders ; Karlsson, Magnus K. LU and Rosengren, Björn E. LU (2020) In Acta Orthopaedica 91(2). p.191-196
Abstract

Background and purpose — We have previously reported on the prosthetic survival of total ankle replacements (TAR) in Sweden performed between 1993 and 2010. Few other reports have been published on 5- and 10-year survival rates. Furthermore, there is a lack of long-term outcome data on modern prosthetic designs. Therefore, we compared early and current prosthetic designs after a mean 7-year follow-up. Patients and methods — On December 31, 2016, 1,230 primary TARs had been reported to the Swedish Ankle Registry. We analyzed prosthetic survival, using exchange or permanent extraction of components as endpoint for 1,226 protheses with mean follow-up of 7 years (0–24). Differences between current (Hintegra, Mobility, CCI, Rebalance, and TM... (More)

Background and purpose — We have previously reported on the prosthetic survival of total ankle replacements (TAR) in Sweden performed between 1993 and 2010. Few other reports have been published on 5- and 10-year survival rates. Furthermore, there is a lack of long-term outcome data on modern prosthetic designs. Therefore, we compared early and current prosthetic designs after a mean 7-year follow-up. Patients and methods — On December 31, 2016, 1,230 primary TARs had been reported to the Swedish Ankle Registry. We analyzed prosthetic survival, using exchange or permanent extraction of components as endpoint for 1,226 protheses with mean follow-up of 7 years (0–24). Differences between current (Hintegra, Mobility, CCI, Rebalance, and TM Ankle) and early prosthetic designs (STAR, BP, and AES) were examined by log rank test. Results — 267/1,226 prostheses (22%) had been revised by December 31, 2016. We found an overall prosthetic survival rate at 5 years of 0.85 (95% CI 0.83–0.87), at 10 years 0.74 (CI 0.70–0.77), at 15 years 0.63 (CI 0.58–0.67), and at 20 years 0.58 (CI 0.52–0.65). For early prosthetic designs the 5- and 10-year survival rates were 0.81 (CI 0.78–0.84) and 0.69 (CI 0.64-0.73) respectively, while the corresponding rates for current designs were 0.88 (CI 0.85–0.91) and 0.84 (CI 0.79–0.88). Current prosthetic designs had better survival (log rank test p < 0.001). Interpretation — Our results point to a positive time trend of prosthetic survival in Sweden; use of current prosthetic designs was associated with better prosthetic survival. Improved designs and instrumentation, more experienced surgeons, and improved patient selection may all have contributed to the better outcome.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
91
issue
2
pages
6 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85077878881
  • pmid:31928101
ISSN
1745-3674
DOI
10.1080/17453674.2019.1709312
language
English
LU publication?
yes
id
3ab81a2a-aa69-46c9-b957-5f73faa8a98a
date added to LUP
2021-01-12 11:21:05
date last changed
2024-06-27 05:59:15
@article{3ab81a2a-aa69-46c9-b957-5f73faa8a98a,
  abstract     = {{<p>Background and purpose — We have previously reported on the prosthetic survival of total ankle replacements (TAR) in Sweden performed between 1993 and 2010. Few other reports have been published on 5- and 10-year survival rates. Furthermore, there is a lack of long-term outcome data on modern prosthetic designs. Therefore, we compared early and current prosthetic designs after a mean 7-year follow-up. Patients and methods — On December 31, 2016, 1,230 primary TARs had been reported to the Swedish Ankle Registry. We analyzed prosthetic survival, using exchange or permanent extraction of components as endpoint for 1,226 protheses with mean follow-up of 7 years (0–24). Differences between current (Hintegra, Mobility, CCI, Rebalance, and TM Ankle) and early prosthetic designs (STAR, BP, and AES) were examined by log rank test. Results — 267/1,226 prostheses (22%) had been revised by December 31, 2016. We found an overall prosthetic survival rate at 5 years of 0.85 (95% CI 0.83–0.87), at 10 years 0.74 (CI 0.70–0.77), at 15 years 0.63 (CI 0.58–0.67), and at 20 years 0.58 (CI 0.52–0.65). For early prosthetic designs the 5- and 10-year survival rates were 0.81 (CI 0.78–0.84) and 0.69 (CI 0.64-0.73) respectively, while the corresponding rates for current designs were 0.88 (CI 0.85–0.91) and 0.84 (CI 0.79–0.88). Current prosthetic designs had better survival (log rank test p &lt; 0.001). Interpretation — Our results point to a positive time trend of prosthetic survival in Sweden; use of current prosthetic designs was associated with better prosthetic survival. Improved designs and instrumentation, more experienced surgeons, and improved patient selection may all have contributed to the better outcome.</p>}},
  author       = {{Undén, Alexandra and Jehpsson, Lars and Kamrad, Ilka and Carlsson, Åke and Henricson, Anders and Karlsson, Magnus K. and Rosengren, Björn E.}},
  issn         = {{1745-3674}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{2}},
  pages        = {{191--196}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Orthopaedica}},
  title        = {{Better implant survival with modern ankle prosthetic designs : 1,226 total ankle prostheses followed for up to 20 years in the Swedish Ankle Registry}},
  url          = {{http://dx.doi.org/10.1080/17453674.2019.1709312}},
  doi          = {{10.1080/17453674.2019.1709312}},
  volume       = {{91}},
  year         = {{2020}},
}