高返修率和再手术率使用 Agile 全踝关节系统。
High revision and reoperation rates using the Agility™ Total Ankle System.
机构信息
Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
Clin Orthop Relat Res. 2012 Jul;470(7):1980-6. doi: 10.1007/s11999-012-2242-6. Epub 2012 Jan 24.
BACKGROUND
Total ankle arthroplasty (TAA) is an evolving treatment for end-stage ankle arthritis, however, there is controversy regarding its longevity.
QUESTIONS/PURPOSES: We determined survival of the Agility™ TAA, the overall reoperation rate, and function in patients who retained their implant.
METHODS
We retrospectively reviewed 64 patients who had 65 TAAs between June 1999 and May 2001. Information was gathered through chart reviews, mailed-in questionnaires, and telephone interviews. Nine patients had died; data were available for 41 of the remaining 55 patients. Survival was based on revision as an end point. The minimum followup was 0.5 years (median, 8 years; range, 0.5-11 years).
RESULTS
Sixteen of the 41 patients (39%) needed revisions. The average time to revision surgery was 4 years with six of the revisions (38%) occurring within 1 year of the TAA. Of the 25 patients who retained their implants, 12 required secondary surgery for an overall reoperation rate of 28 of 41 (68%) at an average of 8 years followup. The average VAS pain score was 4, the average Foot and Ankle Ability Measure (FAAM) sports subscale score was 33, and the average FAAM activities of daily living subscale score was 57.
CONCLUSION
TAA had high revision and reoperation rates. Patients who retained their implant had only moderate pain relief and function. TAA must be approached with caution. More research is needed to elucidate the role of contemporary TAA.
背景
全踝关节置换术（TAA）是治疗终末期踝关节关节炎的一种不断发展的治疗方法，但关于其长期效果仍存在争议。
问题/目的：我们确定了 Agility™ TAA 的存活率、总体再次手术率以及保留植入物的患者的功能。
方法
我们回顾性分析了 1999 年 6 月至 2001 年 5 月期间接受 65 例 TAA 的 64 例患者。通过病历回顾、邮寄问卷和电话访谈收集信息。9 例患者死亡；其余 55 例中有 41 例的数据可用。以翻修为终点来评估存活率。最低随访时间为 0.5 年（中位数 8 年；范围 0.5-11 年）。
结果
41 例患者中有 16 例（39%）需要进行翻修。翻修手术的平均时间为 4 年，其中 6 例（38%）在 TAA 后 1 年内进行。在保留植入物的 25 例患者中，有 12 例因其他疾病需要进行二次手术，总的再次手术率为 41 例中的 28 例（68%），平均随访时间为 8 年。平均视觉模拟评分（VAS）疼痛评分为 4 分，平均足踝能力测量（FAAM）运动亚量表评分为 33 分，平均 FAAM 日常生活活动亚量表评分为 57 分。
结论
TAA 的翻修和再次手术率较高。保留植入物的患者仅获得中度疼痛缓解和功能改善。TAA 的应用必须谨慎。需要进一步的研究来阐明当代 TAA 的作用。
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