Roukis Thomas S, Elliott Andrew D
Attending Staff, Department of Orthopaedics, Podiatry, and Sports Medicine, Gundersen Health System, La Crosse, WI.
Postgraduate Year 2, Podiatric Medicine and Surgery Resident, Gundersen Medical Foundation, La Crosse, WI.
J Foot Ankle Surg. 2015 May-Jun;54(3):311-9. doi: 10.1053/j.jfas.2014.05.005.
The incidence of revision of total ankle replacement prostheses remains unclear. We undertook a systematic review to identify the material relating to the incidence of revision after implantation of the Salto(®) mobile version and Salto Talaris™ total ankle prostheses. Studies were eligible for inclusion only if they had involved primary total ankle replacement with these prostheses and had included the incidence of revision. Eight studies involving 1,209 Salto(®) mobile version prostheses, with a weighted mean follow-up period of 55.2 months, and 5 studies involving 212 Salto Talaris™ total ankle prostheses, with a weighted mean follow-up period of 34.9 months, were included. Forty-eight patients with Salto(®) mobile version prostheses (4%) underwent revision, of whom 24 (70.5%) underwent ankle arthrodesis, 9 (26.5%) metallic component replacement, and 1 (3%) below-the-knee amputation. Five (2.4%) Salto Talaris™ total ankle prostheses underwent revision (3 metallic component replacement and 2 ankle arthrodeses). Restricting the data to the inventor, design team, or disclosed consultants, the incidence of revision was 5.2% for the Salto(®) mobile version and 2.6% for the Salto Talaris™ total ankle prostheses. In contrast, data that excluded these individuals had an incidence of revision of 2.8% for the Salto(®) mobile version and 2.0% for the Salto Talaris™ total ankle prostheses. We could not identify any obvious difference in the etiology responsible for the incidence of revision between these mobile- and fixed-bearing prostheses. The incidence of revision for the Salto(®) mobile version and Salto Talaris™ total ankle prostheses was lower than those reported through systematic review for the Agility™ and Scandinavian Total Ankle Replacement™ systems without obvious selection (inventor) or publication (conflict of interest) bias.
全踝关节置换假体的翻修发生率仍不明确。我们进行了一项系统评价，以确定与Salto（®）活动型和Salto Talaris™全踝关节假体植入后翻修发生率相关的资料。仅当研究涉及使用这些假体进行初次全踝关节置换且包含翻修发生率时，才符合纳入标准。纳入了8项研究，共1209例Salto（®）活动型假体，加权平均随访期为55.2个月；以及5项研究，共212例Salto Talaris™全踝关节假体，加权平均随访期为34.9个月。48例（4%）使用Salto（®）活动型假体的患者接受了翻修，其中24例（70.5%）接受了踝关节融合术，9例（26.5%）进行了金属部件置换，1例（3%）进行了膝下截肢。5例（2.4%）Salto Talaris™全踝关节假体接受了翻修（3例金属部件置换和2例踝关节融合术）。将数据限定于发明者、设计团队或已披露的顾问时，Salto（®）活动型假体的翻修发生率为5.2%，Salto Talaris™全踝关节假体为2.6%。相比之下，排除这些人员的数据中，Salto（®）活动型假体的翻修发生率为2.8%，Salto Talaris™全踝关节假体为2.0%。我们未能发现这些活动型和固定平台假体在翻修发生率的病因方面存在任何明显差异。Salto（®）活动型和Salto Talaris™全踝关节假体的翻修发生率低于对Agility™和斯堪的纳维亚全踝关节置换™系统进行系统评价时所报告的发生率，且无明显的选择（发明者）或发表（利益冲突）偏倚。
