Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstr. 35, 6020 Innsbruck, Austria.
Int Orthop. 2013 Sep;37(9):1677-82. doi: 10.1007/s00264-013-1981-7. Epub 2013 Jul 6.
The data currently available concerning total ankle arthroplasty (TAA) does not allow valid conclusions in several clinically relevant areas. Total ankle arthroplasty imposes special requirements on the methodology of data collection, evaluation, publication and the assessment of register data.
We undertook a structured and descriptive analysis of all outcome data available from high-quality national arthroplasty registers worldwide. Register data from Sweden, Finland, Norway, New Zealand and Australia were included in the analysis.
There are marked differences between Europe and Oceania with respect to indications. All data sets show revision rates of approximately 10 % at five years, of which about 40 % of cases are for aseptic loosening. Inlay fractures are relatively common, which indicates potential for the improvement of implants. The documentation of intraoperative surgical errors leading to revision surgery varies significantly among registers. A relevant number of complications are treated without an implant component being exchanged and therefore not covered by a register.
The results of TAA are promising, but the revision rate is higher than for total hip or knee arthroplasty. TAA outcome measurement by means of registers has several specific requirements necessitating additional documentation beyond the basic data set. For methodological reasons the evaluation of results is more complex than for hip or knee arthroplasty. It will therefore be essential to standardise data collection and evaluation and develop a methodology addressing the specific needs of TAA.
目前有关全踝关节置换术（TAA）的数据在几个临床相关领域无法得出有效结论。TAA 对数据收集、评估、发表的方法以及登记数据的评估提出了特殊要求。
我们对来自全球高质量关节置换登记处的所有可用结局数据进行了结构化和描述性分析。分析中纳入了来自瑞典、芬兰、挪威、新西兰和澳大利亚的登记数据。
在适应证方面，欧洲和大洋洲之间存在显著差异。所有数据集在五年时的翻修率约为 10%，其中约 40%的病例为无菌性松动。嵌体骨折较为常见，这表明有改进植入物的潜力。导致翻修手术的术中手术失误的记录在各登记处之间存在显著差异。相当数量的并发症在不更换植入物的情况下得到治疗，因此未被登记处涵盖。
TAA 的结果有前景，但翻修率高于全髋关节或全膝关节置换术。通过登记处对 TAA 结果进行测量有几个特定要求，需要在基本数据集之外进行额外的记录。由于方法学原因，结果评估比髋关节或膝关节置换术更复杂。因此，标准化数据收集和评估以及制定满足 TAA 特定需求的方法至关重要。
