Fellowship-Trained Foot and Ankle Surgeon, Orthopedic Foot and Ankle Center, Worthington, OH.
Foot and Ankle Surgeon, Grant Medical Center, Columbus, OH.
J Foot Ankle Surg. 2021 Jan-Feb;60(1):67-73. doi: 10.1053/j.jfas.2020.08.023. Epub 2020 Sep 1.
A number of 2-component, fourth-generation total ankle arthroplasty prostheses have been introduced to the market. The purpose of the present study was to present early experience with the CADENCE total ankle prosthesis. All patients who underwent primary total ankle arthroplasty using the prosthesis between August 2016 and June 2018 at a single institution and who were at least 1 year postoperative were included. A total of 32 ankles with a mean follow-up of 24 (range, 12-33) months met the criteria. Weightbearing radiographs were assessed using coronal and sagittal alignment parameters preoperatively, at 6 weeks postoperative, and at the most recent follow-up. Medical records and charts were reviewed and revisions, reoperations, and complications were classified according to the criteria established by Vander Griend et al and Glazebrook et el, respectively. Coronal and sagittal tibiotalar alignment significantly improved after surgery (p < .001, p < .005), and was maintained during the latest follow-up (p = .44, p = .30). Two (6.3%) ankles underwent early revision for aseptic loosening; while 6 (18.8%) underwent a nonrevisional reoperation. Nine (28.1%) ankles presented a total of 13 (4 high grade, 2 intermediate, and 7 low) complications according to the Glazebrook classification. The most common was intraoperative periprosthetic medial malleolar fracture (5 ankles, 15.6%), a low-grade complication. The present study is the first to report early outcomes and experience with the CADENCE total ankle. Overall, survivorship was 94% at short-term follow-up of 2 years. As with all arthroplasty devices, surgeons new to the prosthesis should be cognizant of the potential learning curve. Intraoperative medial malleolar fracture was found to be the most common complication.
已向市场推出了多款 2 组件、第四代全踝关节置换假体。本研究旨在介绍 CADENCE 全踝关节假体的早期经验。在单中心接受该假体初次全踝关节置换术的所有患者，术后至少 1 年，且符合以下条件：1. 接受研究。共 32 例踝关节，平均随访 24 个月（范围 12-33 个月）。术前、术后 6 周及末次随访时拍摄负重正侧位 X 线片，评估冠状面和矢状面的对线参数。回顾病历和图表，并根据 Vander Griend 等和 Glazebrook 等分别建立的标准对翻修、再手术和并发症进行分类。术后冠状面和矢状面胫距关节对线明显改善（p <.001，p <.005），且在末次随访时保持（p = .44，p = .30）。2 例（6.3%）踝关节因无菌性松动行早期翻修；6 例（18.8%）行非翻修再手术。根据 Glazebrook 分类，9 例（28.1%）踝关节共出现 13 例（4 例高级别、2 例中级和 7 例低级）并发症。最常见的并发症是术中假体周围内踝骨折（5 例，15.6%），为低级并发症。本研究首次报道 CADENCE 全踝关节的早期结果和经验。总体而言，2 年的短期随访生存率为 94%。与所有关节置换装置一样，对假体不熟悉的外科医生应认识到潜在的学习曲线。术中内踝骨折被发现是最常见的并发症。
