RESEARCH - Total ankle arthroplasty with the Agility prosthesis: clinical and radiographic evaluation

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Foot Ankle Int. 2006 Feb;27(2):97-103.

Total ankle arthroplasty with the Agility prosthesis: clinical and

radiographic evaluation.

San Diego Orthopaedic Associates, 4060 4th Avenue, 7th Floor, San Diego, CA

92103-2181, USA. franz kopp@...

BACKGROUND: Although ankle arthrodesis remains a standard operative

procedure for disabling ankle arthritis, it has potential long-term

problems. Total ankle arthroplasty offers preserved joint motion and may be

a more favorable option in select patients. The purpose of this study was to

report the intermediate-term clinical and radiographic results of total

ankle arthroplasty using the Agility prosthesis. METHODS: We retrospectively

reviewed the results of total ankle arthroplasty in 41 consecutive patients

(43 ankles). Evaluation included preoperative and postoperative

questionnaires, physical examination, and radiographs. RESULTS: At the time

of followup, 38 patients (40 ankles) were available for review. The most

common preoperative diagnoses included posttraumatic arthritis (24 of 40

ankles, 60%) and rheumatoid arthritis (eight of 40 ankles, 20%). Average age

at surgery was 63 (range 32 to 85) years. Average followup was 44.5 (range

26 to 64) months. Preoperative and postoperative American Orthopaedic Foot

and Ankle Society (AOFAS) Ankle-Hindfoot Scores averaged 33.6 and 83.3,

respectively, demonstrating significance (p < 0.001). Postoperative Medical

Outcomes Study Short Form-36 (SF-36) Physical Component Summary (PCS) and

Mental Component Summary (MCS) scores averaged 49.5 and 56.1, respectively.

Although 34 of 40 ankles demonstrated radiographic lucency or lysis, the

degree of involvement varied. Migration or subsidence of components was

noted in 18 ankles. Overall, 37 of 38 patients were satisfied with the

outcome of their surgery and would have the same procedure under similar

circumstances.

CONCLUSIONS: Agility total ankle arthroplasty results in a

favorable clinical outcome and patient satisfaction in most patients at

intermediate-term followup. However, total ankle arthroplasty is associated

with potential complications and the need for subsequent operative

intervention. Radiographic followup commonly reveals periprosthetic lucency,

lysis, and component migration or subsidence, but this does not appear to

adversely affect the intermediate-term clinical outcome. The long-term

consequences of such radiographic findings are of concern, and surgeons and

patients choosing this procedure need to be cautious.

PMID: 16487461

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus & db=pubmed & cmd=R\

etrieve & dopt=abstractplus & list_uids=16487461

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