A PROSPECTIVE CLINICAL AND RADIOLOGICAL REVIEW OF 137 AES TOTAL ANKLE REPLACEMENTS OVER A 4-YEAR PERIOD IN A SINGLE CENTRE

Abstract

Introduction: We report the clinical and radiological results of 137 AES Total Ankle Replacements (TAR)(Biomet, Europe) over a 4-year period.

Methods: 134 patients underwent 137 Total Ankle Replacements. There were 47 females and 87 males. Three patients underwent bilateral procedures. The mean age of the patients was 64 years (48–78). The main indication for surgery was post-traumatic arthritis other indications included primary arthritis, inflammatory arthritis, haemophilia, haemochromatosis, polio, cavo-varus deformity and revision of a loose STAR. The pre-op coronal deformity ranged from 20 degrees varus to 40 degrees valgus. The same surgeon performed all operations. All patients had a clinical and radiological follow-up at 3, 6 and 12 months then annually, thereafter.

Results: At a mean time to follow up of 18 months the mean AOFAS Hindfoot Score was 79. Excluding those patients with other joint disorders the stratified AOFAS score increases to 81. Four patients experienced postoperative talar subsidence and 8 patients had gaps or lysis around the tibial bone implant interface. Three patients developed soft tissue complications, two of which had to have a split skin graft and one of these developed a deep infection. The third patient required a fascio cutaneous local flap. Thirteen patients required a further procedure for postoperative edge loading. No implant has been revised to date. Two patients feel no better off since surgery and one patient feels worse off. The remainder rate their surgery as good or excellent.

Discussion: The early results of the AES TAR are encouraging. Careful management of the soft tissues and correct soft tissue balancing are important. In our series we have modified the surgical technique so less talar bone is resected.

Conclusion: We feel the AES TAR provides encouraging early results.