Protheroe D, Gadgil A, Davies G
(Advanced Podiatry Practitioner) Hywel Dda Health Board, UK.
(Consultant Orthopaedic Foot and Ankle Surgeon) Hywel Dda Health Board, UK.
J Clin Orthop Trauma. 2025 Feb 16;64:102950. doi: 10.1016/j.jcot.2025.102950. eCollection 2025 May.
This study retrospectively evaluated a consecutive series of patients who underwent Total Ankle Replacement (TAR) with the third-generation mobile bearing Hintegra® prosthesis performed by a single non-designer surgeon. Few studies reporting outcomes from total ankle replacement (TAR) have been published by non-designer investigators. Clinical outcomes, complication and satisfaction rates have also been analysed.
A consecutive series of 52 patients that received 55 TAR were reviewed between 2008 and 2016. Kaplan-Meier survival analysis was performed on all of the 55 TAR. Change in AOFAS hind foot scores from pre to post surgery and self-reported satisfaction scores were analysed.
The 10 year survival analysis group had a minimal mean follow up of 10 years (SD 1.5, median 8.5, min 7.0. max 12.9), with a survival rate of 87 % (CI 0.74 to 0.94). Five-year survival rate was 93 % (CI 0.82 to 0.97). Six ankles (11 %) had to be revised. One having a talar component revision with polyethylene exchange and the remaining five with a conversion to arthrodesis. Only thirty-eight of the original 55 TAR were analysed for outcome measures. Seventeen patients were lost to follow up and 19 patients were deceased. In total 79 % (30) patients were satisfied with the TAR procedure with sixteen patients reporting to be extremely satisfied. Sixteen per cent (6) patients reported to be neutral and only 5 % (2) patients stated that they were not satisfied with the TAR procedure.
Our results show that the Hintegra® TAR prosthesis leads to good medium to long term survivorship and acceptable patient satisfaction rates. The results of these cases, all treated by a single non-designer surgeon in a low-volume practice, demonstrate that acceptable outcomes may be achieved outside of high-volume TAR centres.
Retrospective analysis - Level III.
本研究回顾性评估了由一位非假体设计者的外科医生使用第三代活动轴承Hintegra®假体进行全踝关节置换（TAR）的一系列连续患者。非设计者研究人员发表的关于全踝关节置换（TAR）结果的研究很少。还分析了临床结果、并发症和满意率。
回顾了2008年至2016年间连续接受55次TAR的52例患者。对所有55次TAR进行了Kaplan-Meier生存分析。分析了术前至术后AOFAS后足评分的变化以及自我报告的满意度评分。
10年生存分析组的平均随访时间最短为10年（标准差1.5，中位数8.5，最小值7.0，最大值12.9），生存率为87%（可信区间0.74至0.94）。5年生存率为93%（可信区间0.82至0.97）。6个踝关节（11%）需要翻修。1例进行了距骨部件翻修并更换聚乙烯，其余5例改为关节融合术。仅对最初55次TAR中的38次进行了结果测量分析。17例患者失访，19例患者死亡。总计79%（30）的患者对TAR手术满意，16例患者报告非常满意。16%（6）的患者报告态度中立，只有5%（2）的患者表示对TAR手术不满意。
我们的结果表明，Hintegra® TAR假体可实现良好的中长期生存率和可接受的患者满意率。这些病例均由一位非假体设计者的外科医生在低手术量的实践中进行治疗，结果表明在高手术量的TAR中心之外也可取得可接受的结果。
回顾性分析 - 三级。
