Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK.
Bone Joint J. 2021 Apr;103-B(4):696-703. doi: 10.1302/0301-620X.103B4.BJJ-2020-0758.R1.
We report the medium-term outcomes of a consecutive series of 118 Zenith total ankle arthroplasties (TAAs) from a single, non-designer centre.
Between December 2010 and May 2016, 118 consecutive Zenith prostheses were implanted in 114 patients. Demographic, clinical, and patient-reported outcome measures (PROMs) data were collected. The endpoint of the study was failure of the implant requiring revision of one or all of the components. Kaplan-Meier survival curves were generated with 95% confidence intervals (CIs) and the rate of failure calculated for each year.
Eight patients (ten ankles) died during follow-up, but none required revision. Of the surviving 106 patients (108 ankles: rheumatoid arthritis (RA), n = 15; osteoarthritis (OA), n = 93), 38 were women and 68 were men, with a mean age of 68.2 years (48 to 86) at the time of surgery. Mean follow-up was 5.1 years (2.1 to 9.0). A total of ten implants failed (8.5%), thus requiring revision. The implant survival at seven years, using revision as an endpoint, was 88.2% (95% CI 100% to 72.9%). There was a mean improvement in Manchester-Oxford Foot and Ankle Questionnaire (MOXFQ) from 85.0 to 32.8 and visual analogue scale (VAS) scores from 7.0 to 3.2, and overall satisfaction was 89%. The three commonest complications were malleolar fracture (14.4%, n = 17), wound healing (13.6%, n = 16), and superficial infection (12.7%, n = 15). The commonest reason for revision was aseptic loosening. No patients in our study were revised for deep infection.
Our results show that Zenith survival rates are comparable with those in the literature for other implants and in the National Joint Registry (NJR). Overall patient satisfaction was high as were functional outcomes. However, the data highlight potential complications associated with this surgery. The authors believe that these figures support ankle arthroplasty as an option in the treatment of ankle arthritis. Cite this article: 2021;103-B(4):696-703.
我们报告了来自一个单一非设计中心的 118 例连续系列 Zenith 全踝关节置换术（TAA）的中期结果。
2010 年 12 月至 2016 年 5 月，连续植入 114 例患者的 118 例 Zenith 假体。收集人口统计学、临床和患者报告的结局测量（PROM）数据。本研究的终点是需要对一个或所有组件进行翻修的植入物失败。使用 95%置信区间（CI）生成 Kaplan-Meier 生存曲线，并计算每年的失败率。
随访期间有 8 例患者（10 例踝关节）死亡，但均无需翻修。在幸存的 106 例患者（108 例踝关节：类风湿关节炎（RA），n=15；骨关节炎（OA），n=93）中，38 例为女性，68 例为男性，手术时的平均年龄为 68.2 岁（48 至 86）。平均随访时间为 5.1 年（2.1 至 9.0）。共有 10 例植入物失败（8.5%），因此需要翻修。使用翻修为终点，7 年时的植入物存活率为 88.2%（95%CI 100%至 72.9%）。曼彻斯特-牛津足部和踝关节问卷（MOXFQ）平均从 85.0 分提高到 32.8 分，视觉模拟量表（VAS）评分从 7.0 分提高到 3.2 分，总体满意度为 89%。最常见的三种并发症是外踝骨折（14.4%，n=17）、伤口愈合不良（13.6%，n=16）和浅表感染（12.7%，n=15）。最常见的翻修原因是无菌性松动。我们研究中没有患者因深部感染而接受翻修。
我们的结果表明，Zenith 的存活率与文献中其他植入物和国家关节登记处（NJR）的存活率相当。患者的总体满意度高，功能结果也很好。然而，数据突出了与这种手术相关的潜在并发症。作者认为，这些数据支持踝关节置换术作为治疗踝关节关节炎的一种选择。
2021;103-B（4）：696-703.
