Abstract
Introduction: We present the results of 35 patients following Ankle Evolution System (AES) total ankle replacements (TAR) with a minimum follow up of four years.
Methods: We retrospectively reviewed 39 consecutive total ankle replacements. Two patients died, and two emigrated. Thirty-five patients were available for clinical and radiological assessment. All patients underwent standardised radiographs. Complications and failures were recorded. Patient satisfaction and functional outcome of all patients was determined using the American orthopaedic foot and ankle society (AOFAS) score.
Results: All ankles were examined at a mean of 4.7 years postoperatively. The mean age at operation was 64 years. In 18 ankles the indication for the operation was primary osteoarthritis (OA), in 13 ankles post-traumatic OA, in three ankles rheumatoid arthritis and in one ankle psoriatic arthropathy. One patient had revision of the tibial component because of loosening. Sixteen patients recorded their satisfaction as excellent postoperatively, 15 patients as much better, three as better and only one patient recorded that he was worse off. The mean AOFAS score was 88.9 (confidence interval 85.7–92.1). The mean walking distance for our cohort is two miles. Thirteen ankles had radiological osteolysis; in two ankles this was more that 2cms.
Conclusion: The medium term results after implantation of the AES ankle prosthesis are encouraging. With the correct indication, a high rate of pain reduction and patient satisfaction can be achieved. The long-term benefit of this procedure has yet to be determined. The rate of osteolysis is of some concern.
Correspondence should be addressed to A.H.N. Robinson, BOX 37, Department of Orthopaedics, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Trust, Hills Road, Cambridge. CB2 0QQ, England.
