Introduction:. We present the early results of 220 Rebalance Total Ankle Replacements performed in 6 centres in 4 different countries. Methods:. The Rebalance Total Ankle Replacement is a new 3 component uncemented mobile bearing prosthesis with a surface coating of ‘bonemaster’ and an ‘e’ poly bearing. The prosthesis was released in a limited way in May 2011. Since then 220 replacements have been implanted in 218 patients in 6 centres in 4 different countries (UK, Sweden, Canada, Czech Republic). All the x-rays and case notes were reviewed.63 prostheses have a minimum follow up of 2 years. Outcome measures included revision of the prosthesis, and the incidence of progressive and non-progesssive radiolucent lines around the prosthesis. Results:. 7 patients underwent revision or are awaiting revision of their prosthesis. Reasons for revision included loosening(2), infection(1), malposition(2), periprosthetic fracture(1), impingement(1). 9 patients had non-progressive radiolucent lines and 2 patients had progressive radiolucent lines. 1 patient with progressive radiolucent lines is waiting revision for suspected infection. 8 patients suffered fractures to the lateral malleolus and 4 to the medial malleolus. There were no cases of balloon osteolysis. 29 patients had pre-op AOFAS scores= 41(12–67). 21 had 1 year post-op AOFAS scores= 73.5(26–100). 12 had 2 year AOFAS scores= 75.5(50–100). Conclusion:. The early results are encouraging and we believe support its wider use

Introduction:. This study evaluates the mid-term results of first metatarsophalangeal joint replacement (MTPJR) for hallux rigidus using the Toefit-Plus™ prosthesis. Methods:. We prospectively studied the outcomes of 86 MTPJR in 73 patients using the AOFAS-HMI score and radiological follow up over a period from 2006 to 2013, with surgeries performed by a single surgeon at two centres. Patients were reviewed, scored and radiographs obtained pre-operatively and then at intervals of 6 weeks, 6 months, 12 months and then yearly. The mean follow up was 33 months (2–72). Results:. The mean AOFAS score of the patients not requiring revision at 1 year was 92, at 2 years was 94, at 3 years was 91, at 4 years was 99, at 5 years was 93, at 6 years was 100 and at 7 years was 97. 18 joints have either been revised or listed for revision giving a revision rate of 21%; this occurred at a mean of 33 months post-surgery. Reasons for revision included loosening of components in 13, infection in 1, dislocation in 2, malalignment in 1 and persistent pain in 1. Eight patients sustained intra-operative fractures requiring circlage wiring, of which 7 went on to union and one required revision. 25 patients had evidence of radiological loosening of which 22 were around the phalangeal component and 3 were around the metatarsal component. Conclusions:. First MTPJ replacement resulted in improved outcomes in patients with hallux rigidus who do not require revision in the medium term, however the revision rate is unacceptably high and as such we have discontinued use of this prosthesis. Radiological loosening of the components is high and needs monitoring for progression which may necessitate revision