Purpose: Ankle fusion provides relief of symptoms for end stage ankle arthritis, but arthritis in surrounding joints as well as loss of motion limit the outcomes of this procedure. Total ankle arthroplasty may avoid these issues. The purpose of this study is to, with several clinical outcome scores, determine the outcomes achieved by those patients who received agility TAA from 2 senior surgeons at a Canadian institution.
Method: Between March 2003 and November 2005 thirty-three agility total ankle replacements were placed in thirty-two patients by two senior foot and ankle fellowship trained surgeons at the BC foot and ankle center. Each patient pre-operatively filled out the American academy of orthopaedic surgery function score (AAOS), ankle osteoarthritis scale (AOS), foot function index (FFI), ankle-hindfoot (AHS). The patient was then prospectively followed-up with the same questionnaires at 6 months, 1 year and again at 2 years.
Results: Post-operatively significant reduction in pain were found in all 5 surveys. AHS found significant improvements in level of pain (p<
0.001 in 7 domains and p = 0.01, and p = 0.02 in the 2 additional domain. With respect to post-operrative mobility. The AHS showed significant increases in flexion and extension (p = 0.02) of the affected ankle. This score also showed significant post-operative improvements in subjective sense of ankle stability (p <
0.001), alignment (p=0.01), and level of activity. (p <
0.001) Of the 32 agility total ankles that were installed, 31/32 (97%) were still in place at the conclusion of this study. Only 1 (3%) required revision. The overall complication rate was 16/32 (50%) with the majority of complications being impingement (8/32; 25%) and superficial wound breakdown (4/32; 12.5%). The re-operation rate was 6/32 (19%). There were no amputations or conversion to fusions.
Conclusion: Patients with agility TAA as evaluated at this Canadian institution, showed significant reductions in post-operative pain and increased foot and ankle mobility. The agility TAA, when considered in the context of the patient and their demands, can be a relatively safe and durable method of treatment for ankle arthritis.
