Outcomes of revision surgery for failed total ankle replacement: revision arthroplasty versus arthrodesis

摘要

Purpose To compare the short-term outcomes of surgical management of failed ankle arthroplasty with revision ankle arthroplasty and conversion to arthrodesis. Methods Single-centre retrospective review of revision procedures for failed ankle arthroplasty between January 2012 and June 2019. Implant survival, union rates, and PROMS data-Pain Visual Analogue Score (VAS), Ankle Osteoarthritis Score (AOS) and Manchester-Oxford Foot Questionnaire (MOxFQ)-were compared between the two groups. Results Twenty-nine patients (31 ankles) underwent surgical management for failed ankle arthroplasty, with either revision arthroplasty (n = 21) or arthrodesis (n = 10). Revision arthroplasty had 87% survival at four years. Arthrodesis had an overall union rate of 80%. Two-year PROMS showed greater results for the revision arthroplasty group compared with that for arthrodesis group (Pain VAS 10 vs 50,p = 0.03; total AOS 12 vs 87,p = 0.04; average MOxFQ 17 vs 73.5,p0.02). Conclusion Revision arthroplasty demonstrates good short-term survival data with improvements in PROMS compared with arthrodesis. Further long-term follow-up is required to monitor if these benefits continue.