McCahon Joseph A S, Radack Tyler, Thalody Hope, Lencer Adam, Bridges Tiffany, Moncman Tara G, Pedowitz David I, Parekh Selene G, Daniel Joseph N
Jefferson Health - New Jersey, Stratford, NJ, USA.
Rothman Orthopaedic Institute, Philadelphia, PA, USA.
Foot Ankle Int. 2025 Jul;46(7):757-764. doi: 10.1177/10711007251336752. Epub 2025 May 22.
Polyethylene wear particles have been shown to be a contributing factor of osteolysis and aseptic loosening. To date, no clinical study has investigated the in vivo wear rates of Salto Talaris total ankle arthroplasty (TAA). Therefore, the purpose of our study was to evaluate mid- and long-term outcomes and in vivo wear rates in primary total ankle arthroplasty and their association with peri-implant osteolysis, complications, and implant survivorship.
A retrospective review was performed to determine the mid- and long-term in vivo polyethylene wear rates in primary TAA. Patients with a minimum of 5-year clinical and radiographic data from a primary TAA with a fixed-bearing, semiconstrained, ultrahigh-molecular-weight polyethylene (UHMWPE) system were identified and included in this study. Polyethylene wear rates at final follow-up were analyzed using anteroposterior ankle radiographs and a validated computer-assisted Roman software. In addition, demographic data, peri-implant osteolysis, complications, reoperations, and revisions were recorded.
Fifty-four patients with a mean follow-up of 8.1 years (range, 5.2-13.0) were included in this study. The median polyethylene wear rate for the entire cohort was 0.06 mm/y (95% CI 0.04-0.08). Linear wear rate was found to have no true correlation relationship with patient age, BMI, or polyethylene size. More than half of patients (57%) demonstrated some radiographic signs of peri-implant osteolysis or cysts at final follow-up; however, comparative analysis investigating the relationship between wear rate and peri-implant osteolysis found no significant difference in wear rates for patients with tibial or talar osteolysis compared with those without ( = .451 and = .434, respectively).
UHMWPE in this primary TAA demonstrated low in vivo wear rates. Rates of peri-implant osteolysis remain high with no clear association between wear rates and osteolysis.
聚乙烯磨损颗粒已被证明是骨溶解和无菌性松动的一个促成因素。迄今为止，尚无临床研究调查过 Salto Talaris 全踝关节置换术（TAA）的体内磨损率。因此，我们研究的目的是评估初次全踝关节置换术的中长期疗效和体内磨损率，以及它们与植入物周围骨溶解、并发症和植入物生存率的关系。
进行一项回顾性研究，以确定初次 TAA 的中长期体内聚乙烯磨损率。纳入了来自使用固定承重、半限制性、超高分子量聚乙烯（UHMWPE）系统的初次 TAA 且有至少 5 年临床和影像学数据的患者。使用踝关节前后位 X 光片和经过验证的计算机辅助 Roman 软件分析末次随访时的聚乙烯磨损率。此外，记录人口统计学数据、植入物周围骨溶解、并发症、再次手术和翻修情况。
本研究纳入了 54 例患者，平均随访时间为 8.1 年（范围为 5.2 - 13.0 年）。整个队列的聚乙烯磨损率中位数为 0.06 mm/年（95%CI 0.04 - 0.08）。发现线性磨损率与患者年龄、体重指数或聚乙烯尺寸无真正的相关性。超过一半的患者（57%）在末次随访时表现出一些植入物周围骨溶解或囊肿的影像学迹象；然而，调查磨损率与植入物周围骨溶解之间关系的对比分析发现，有胫骨或距骨骨溶解的患者与无骨溶解的患者相比，磨损率无显著差异（分别为 = 0.451 和 = 0.434）。
这种初次 TAA 中的 UHMWPE 体内磨损率较低。植入物周围骨溶解的发生率仍然很高，磨损率与骨溶解之间没有明确的关联。
