RESEARCH - Perioperative complications of the Agility total ankle replacement in 50 initial, consecutive cases

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J Foot Ankle Surg. 2006 May-Jun;45(3):139-46.

Perioperative complications of the Agility total ankle replacement in 50

initial, consecutive cases.

Department of Orthopedic Surgery, Kaiser Permanente-French Campus, 450 6th

Ave, San Francisco, CA 94118, USA.

Although functional and clinical outcomes after total ankle arthroplasty

have been promising, a steep learning curve has been recognized. In

addition, the performance of concomitant hindfoot realignment procedures is

controversial. The purpose of this study was to report on a single surgeon's

experience with the first 50 total ankle arthroplasty procedures. We wanted

to define the characteristics of the learning curve and whether the rate of

complications was increased in patients who required complex reconstruction

for preexistent foot and ankle deformities. This was a retrospective study

of 50 cases with an average follow-up of 24.2 months. The patient population

consisted of 18 men and 30 women with an average age of 57.6 years.

Twenty-six percent of the cases had concomitant bony realignment procedures,

while 20% had prior history of major hindfoot corrective procedures. There

were 19 cases with intraoperative malleolar fractures, 12 cases that

exhibited some degree of malalignment, and 6 cases of syndesmotic nonunion,

and 8 ankles required early component revision. Minor wound complications

that resolved with local wound care occurred in 9 cases, while 1 patient had

a major wound complication requiring flap coverage. Each of these

complications, other than wound complications, decreased with the surgeon's

experience. Our results also indicate that the performance of major

realignment procedures at the same time of implant arthroplasty is not

associated with an increased incidence of complications. The results of this

study suggest that total ankle arthroplasty is associated with a learning

curve. Perioperative complications may potentially decrease with surgeon

experience.

PMID: 16651192

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16651192

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