Doty Jesse, Murphy G Andrew, Bohay Donald, Fortin Paul, Vora Anand, Strasser Nicholas, Friscia David, Newton William, Gross Christopher E
University of Tennessee/Erlanger Orthopaedics, Chattanooga, TN, USA.
Campbell Clinic, Memphis, TN, USA.
Foot Ankle Int. 2024 Feb;45(2):150-157. doi: 10.1177/10711007231212484. Epub 2023 Dec 22.
The INFINITY total ankle implant is a widely and successfully used option for total ankle arthroplasty. The purpose of this study is to assess the 2-year survivorship, complication rates, patient-reported outcomes, and radiologic findings of prospectively enrolled patients undergoing a fixed-bearing total ankle arthroplasty (TAA). This study sought to determine if factors such as traditional vs patient-specific instrumentation, preoperative degree of arthritis, deformity, or etiology of arthritis impact surgical or clinical outcomes.
A total of 143 prospectively enrolled patients (148 ankles) underwent TAA with a fixed-bearing total ankle implant between 2017 and 2019 at 9 different institutions by 9 different surgeons. A total of 116 completed 2-year follow-up. Patients were stratified by instrumentation used, degree of preoperative deformity, the Canadian Orthopaedic Foot and Ankle Society (COFAS) grading system, and etiology of arthritis. Outcomes used included implant survivorship and adverse events within 2 years of surgery. Additionally, patient-reported outcomes and radiographs were collected at 6-month, 1-year, and 2-year postoperatively. PROMs used included Ankle Osteoarthritis Score (AOS), Patient-Reported Outcomes Measurement Information System (PROMIS) global health score, the Foot and Ankle Outcome Score (FAOS), and patient satisfaction (rated from excellent to poor).
Implant survivorship at 2 years was 97.79%. There were 17 reoperations (11.5%), with 4 of the implants requiring revision (2.7%). Significant improvements in all PROMs were observed among all subgroups at all postoperative time points without significant variation between subgroups. Patients classified as COFAS type 2 arthritis preoperatively demonstrated significantly more improvement in FAOS Total Symptom Score at the 1- and 2-year measurements than COFAS type 3 patients at both time points.
Total ankle arthroplasty with a fixed-bearing implant system is a safe and reliable treatment option for patients with end-stage arthritis regardless of degree of deformity or COFAS grading.
Level II, prospective cohort study.
INFINITY全踝关节置换植入物是全踝关节置换术中广泛且成功应用的一种选择。本研究的目的是评估前瞻性纳入的接受固定承重全踝关节置换术（TAA）患者的2年生存率、并发症发生率、患者报告的结局以及影像学检查结果。本研究旨在确定诸如传统器械与定制器械、术前关节炎程度、畸形或关节炎病因等因素是否会影响手术或临床结局。
2017年至2019年期间，9位不同的外科医生在9个不同机构为总共143例前瞻性纳入的患者（148个踝关节）进行了使用固定承重全踝关节植入物的TAA手术。共有116例患者完成了2年随访。患者按所用器械、术前畸形程度、加拿大矫形足踝协会（COFAS）分级系统以及关节炎病因进行分层。所使用的结局指标包括植入物2年内的生存率和不良事件。此外，在术后6个月、1年和2年收集患者报告的结局和X线片。所使用的患者报告结局测量指标包括踝关节骨关节炎评分（AOS）、患者报告结局测量信息系统（PROMIS）总体健康评分、足踝结局评分（FAOS）以及患者满意度（从优到差进行评分）。
2年时植入物生存率为97.79%。有17例再次手术（11.5%），其中4例植入物需要翻修（2.7%）。在所有术后时间点，所有亚组的所有患者报告结局测量指标均有显著改善，各亚组之间无显著差异。术前被分类为COFAS 2型关节炎的患者在1年和2年测量时，FAOS总症状评分的改善明显多于COFAS 3型患者在这两个时间点的改善。
对于终末期关节炎患者，无论畸形程度或COFAS分级如何，采用固定承重植入系统的全踝关节置换术都是一种安全可靠的治疗选择。
二级，前瞻性队列研究。
