Glazebrook Mark A, Arsenault Kory, Dunbar Michael
Dalhousie University, Division of Orthopaedics, Room 4867 Halifax Infirmary, Queen Elizabeth II Health Sciences Center, 1796 Summer Street, Halifax, Nova Scotia B3H 3A7, Canada.
Foot Ankle Int. 2009 Oct;30(10):945-9. doi: 10.3113/FAI.2009.0945.
Total ankle arthroplasty (TAA) has become a viable treatment for end-stage ankle arthrosis. Current literature on survival rates and complications of TAA consist of mostly retrospective Level IV papers that do not provide a system for classifying complications. The aim of the current review is to provide a summary of TAA implant survival and complication rates from current literature on outcomes of second or third generation ankle prostheses and subsequently propose a classification system.
A literature review was used to identify articles reporting complications and failures of TAA ankle prostheses. Inclusion criteria included studies with at least 25 cases and a minimum of 24 months followup.
Twenty studies met the inclusion criteria. The percentage of failed TAA reported for the short- and intermediate-term followup in this review ranged from 1.3 to 32.3 % with an overall mean of 12.4 % failure at 64 months. Nine main complications of TAA were identified.
Deep infection, aseptic loosening and implant failure should be considered ;;high-grade'' complications since they will result in failure greater than 50% of the time. Technical error, subsidence and postoperative bone fracture should be considered "medium-grade'', while intra-op bone fractures and wound healing problems should be considered "low-grade''. We believe this review provides the groundwork for uniform complication reporting in TAA and allows the development of a classification system that will provide prognostic information that may serve to guide postoperative care of patients receiving TAA.
全踝关节置换术（TAA）已成为终末期踝关节骨性关节炎的一种可行治疗方法。目前关于TAA生存率和并发症的文献大多是回顾性的IV级论文，没有提供并发症分类系统。本综述的目的是总结当前关于第二代或第三代踝关节假体结局的文献中TAA植入物的生存率和并发症发生率，并随后提出一种分类系统。
采用文献综述来识别报告TAA踝关节假体并发症和失败情况的文章。纳入标准包括至少有25例病例且随访至少24个月的研究。
20项研究符合纳入标准。本综述中报告的短期和中期随访中TAA失败的百分比范围为1.3%至32.3%，64个月时总体平均失败率为12.4%。确定了TAA的9种主要并发症。
深部感染、无菌性松动和植入物失败应被视为“高级别”并发症，因为它们导致失败的概率超过50%。技术失误、下沉和术后骨折应被视为“中级别”，而术中骨折和伤口愈合问题应被视为“低级别”。我们认为本综述为TAA中统一的并发症报告提供了基础，并允许开发一种分类系统，该系统将提供可用于指导接受TAA患者术后护理的预后信息。
