Hospital for Special Surgery, New York, NY, USA.
Foot Ankle Int. 2020 Dec;41(12):1519-1528. doi: 10.1177/1071100720947030. Epub 2020 Aug 14.
The Salto Talaris is a fixed-bearing implant first approved in the US in 2006. While early surgical outcomes have been promising, mid- to long-term survivorship data are limited. The aim of this study was to present the survivorship and causes of failure of the Salto Talaris implant, with functional and radiographic outcomes.
Eighty-seven prospectively followed patients who underwent total ankle arthroplasty with the Salto Talaris between 2007 and 2015 at our institution were retrospectively identified. Of these, 82 patients (85 ankles) had a minimum follow-up of 5 (mean, 7.1; range, 5-12) years. The mean age was 63.5 (range, 42-82) years and the mean body mass index was 28.1 (range, 17.9-41.2) kg/m. Survivorship was determined by incidence of revision, defined as removal/exchange of a metal component. Preoperative, immediate, and minimum 5-year postoperative AP and lateral weightbearing radiographs were reviewed; tibiotalar alignment (TTA) and the medial distal tibial angle (MDTA) were measured to assess coronal talar and tibial alignment, respectively. The sagittal tibial angle (STA) was measured; the talar inclination angle (TIA) was measured to evaluate for radiographic subsidence of the implant, defined as a change in TIA of 5 degrees or more from the immediately to the latest postoperative lateral radiograph. The locations of periprosthetic cysts were documented. Preoperative and minimum 5-year postoperative Foot and Ankle Outcome Score (FAOS) subscales were compared.
Survivorship was 97.6% with 2 revisions. One patient underwent tibial and talar component revision for varus malalignment of the ankle; another underwent talar component revision for aseptic loosening and subsidence. The rate of other reoperations was 21.2% ( = 18), with the main reoperation being exostectomy with debridement for ankle impingement ( = 12). At final follow-up, the average TTA improved 4.4 (± 3.8) degrees, the average MDTA improved 3.4 (± 2.6) degrees, and the average STA improved 5.3 (± 4.5) degrees. Periprosthetic cysts were observed in 18 patients, and there was no radiographic subsidence. All FAOS subscales demonstrated significant improvement at final follow-up.
We found the Salto Talaris implant to be durable, consistent with previous studies of shorter follow-up lengths. We observed significant improvement in radiographic alignment as well as patient-reported clinical outcomes at a minimum 5-year follow-up.
Level IV, retrospective case series.
Salto Talaris 是一种固定轴承植入物，于 2006 年首次在美国获得批准。虽然早期的手术结果很有希望，但中至长期的存活率数据有限。本研究的目的是介绍 Salto Talaris 植入物的存活率和失败原因，并提供功能和影像学结果。
我们回顾性地确定了 2007 年至 2015 年在我们机构接受 Salto Talaris 全踝关节置换术的 87 例前瞻性随访患者。其中，82 例患者（85 个踝关节）的随访时间至少为 5 年（平均 7.1 年；范围，5-12 年）。平均年龄为 63.5 岁（范围，42-82 岁），平均体重指数为 28.1（范围，17.9-41.2）kg/m。存活率通过修订来确定，定义为金属部件的移除/更换。回顾了术前、即刻和至少 5 年的术后前后位和侧位负重 X 线片；测量胫距关节（TTA）和内侧远端胫骨角（MDTA），分别评估冠状距骨和胫骨的对线情况。测量矢状胫骨角（STA）；测量距骨倾斜角（TIA）以评估植入物的影像学下沉，定义为 TIA 从即刻到最晚术后侧位 X 线片的变化为 5 度或以上。记录了假体周围囊肿的位置。比较了术前和至少 5 年的足部和踝关节结果评分（FAOS）亚量表。
存活率为 97.6%，有 2 例需要翻修。1 例患者因踝关节内翻畸形行胫骨和距骨组件翻修；另 1 例因无菌性松动和下沉而行距骨组件翻修。其他再手术的发生率为 21.2%（=18），主要再手术为踝关节撞击症的骨切除术和清创术（=12）。最终随访时，TTA 平均改善 4.4（±3.8）度，MDTA 平均改善 3.4（±2.6）度，STA 平均改善 5.3（±4.5）度。18 例患者出现假体周围囊肿，无影像学下沉。所有 FAOS 亚量表在最终随访时均有显著改善。
我们发现 Salto Talaris 植入物具有耐用性，与之前较短随访时间的研究结果一致。我们在至少 5 年的随访中观察到影像学对线和患者报告的临床结果有显著改善。
IV 级，回顾性病例系列。
