1 Slotervaart Center of Orthopaedic Research & Education (SCORE), Department of Orthopaedic Surgery, MC Slotervaart, Amsterdam, the Netherlands.
2 Orthopaedic Research Centre Amsterdam, Department of Orthopaedic Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
Foot Ankle Int. 2019 May;40(5):553-561. doi: 10.1177/1071100719828379. Epub 2019 Jan 30.
Total ankle replacement (TAR) is gaining popularity as a treatment option for ankle osteoarthritis. Long-term implant survival is a critical outcome to determine the success of the TAR implant. The Buechel-Pappas (BP) implant is a second-generation mobile bearing implant. The aim of this study was to analyze the BP implant survivorship at 10-year follow-up, make a subanalysis between patient groups, and evaluate long-term functional outcomes.
Data of 86 patients who received 101 BP implants between 1993 and 2010 were obtained from a prospectively documented database. Subanalyses were done for patients diagnosed with inflammatory joint disease and noninflammatory joint disease, and patients with preoperative tibiotalar neutral and nonneutral alignment. A Kaplan-Meier curve was used for survival analysis. Long-term functional outcomes were assessed with the following patient-reported outcome measures: Foot and Ankle Outcome Score (FAOS), Foot and Ankle Ability Measure (FAAM), Short Form-36 (SF-36) Stand Version 2.0 Health Survey and 3 anchor questions.
The survival rate of the BP implant at 10 years was 86% (95% confidence interval, 78%-93%). A total of 31 patients (36%) required 55 reoperations, and in 13 patients (15%) a revision procedure was performed. In this series, no significant difference in 10-year survival rate was found between neither the inflammatory joint disease and noninflammatory joint disease group ( P = .47), nor the tibiotalar neutral and nonneutral alignment group ( P = .16). At a mean follow-up of 16.8 years for 21 patients, the mean FAOS activities of daily living (ADL) and FAAM ADL subscale scores were 75/100 and 56/100 points. The mean physical component summary (PCS) and mental component summary (MCS) of the SF-36 were 34/100 and 51/100 points, respectively.
A survival rate of 86% was found at 10-year follow-up for the Buechel-Pappas implant. Our series demonstrated no significant difference in 10-year survival rates between the 2 patient subgroups. Long-term results of the various functional outcomes varied between poor and moderate.
Level II, prospective cohort study.
全踝关节置换术（TAR）作为治疗踝关节骨关节炎的一种选择越来越受到欢迎。植入物的长期存活率是确定 TAR 植入物成功与否的关键结果。Buechel-Pappas（BP）植入物是一种第二代活动衬垫植入物。本研究的目的是分析 BP 植入物在 10 年随访时的存活率，对患者组进行亚分析，并评估长期功能结果。
从一个前瞻性记录的数据库中获得了 1993 年至 2010 年间接受 101 个 BP 植入物的 86 名患者的数据。对诊断为炎性关节病和非炎性关节病的患者以及术前距下关节中立和非中立位置的患者进行了亚分析。采用 Kaplan-Meier 曲线进行生存分析。使用以下患者报告的结果测量来评估长期功能结果：足踝结果评分（FAOS）、足踝能力测量（FAAM）、短格式 36 健康调查 2.0 版（SF-36）站立版本和 3 个锚定问题。
BP 植入物的 10 年生存率为 86%（95%置信区间，78%-93%）。共有 31 名患者（36%）需要进行 55 次翻修手术，13 名患者（15%）进行了翻修手术。在本系列中，炎性关节病和非炎性关节病组之间（P=0.47）以及距下关节中立和非中立位置组之间（P=0.16）均未发现 10 年生存率有显著差异。在 21 名患者的平均随访 16.8 年后，FAOS 日常生活活动（ADL）和 FAAM ADL 子量表的平均评分分别为 75/100 和 56/100 分。SF-36 的物理成分综合评分（PCS）和心理成分综合评分（MCS）分别为 34/100 和 51/100 分。
BP 植入物在 10 年随访时的生存率为 86%。我们的研究表明，两个患者亚组之间的 10 年生存率无显著差异。各种功能结果的长期结果在较差和中等之间变化。
II 级，前瞻性队列研究。
