Hi, my name is Jaehyun Kim, and today I'll be presenting the short-term results of the Cadence Toro-Ankle System. This is our disclosures. Cadence is a first-generation, two-component, fixed-bearing toro-ankle replacement system that has been in clinical use since 2016. It features a more anatomic design compared to previous generation implants, with a TBR-based plate with a fibular surface and a talon implant with a conical axis of rotation. There are a few short-term outcome studies showing favorable clinical and radiological outcomes of Cadence implants, however, these outcome reports are limited by funded research or the designer's experience. Therefore, the purpose of this study was to determine the non-inventor, non-industry-funded outcomes of the Cadence toro-ankle replacement system at a minimum of a two-year follow-up. This was a retrospective study on patients who underwent Cadence TAA between 2017 and 2018 and completed a minimum of a two-year follow-up. One patient who became diseased and one who refused to participate in the study were excluded. 48 ankles in 48 patients with a mean age of 66 years were included, and the mean follow-up for these patients were 33 months. There were 33 patients with post-traumatic ankle arthritis, 13 with primary osteoarthritis, and two who had ankle arthritis due to systematic diseases. The radiographic assessment included tibial-talar angle and sagittal-tibial angle. Significant lucency was defined as a hypodense zone greater than 5 mm in diameter. As depicted in the figure, the locations of lucency were established using a zone classification system. PROMISE scores were used to evaluate clinical outcomes. Revision, reoperation, and complications were documented following the COFAS coding system. There were three revisions, one due to infection and two due to component loosening, leaving us with a survival rate of 93.8%. There were three reoperations, leaving the reoperation rate at 6.3%. Two were due to superficial infections requiring IND, and one was due to medial gutter impingement necessitating gutter debris mound. There were four complications that were not associated with revisions or reoperations. Postoperatively, radiographic parameters changed significantly, with all patients exhibiting neutral TTA. There were 15 patients with significant lucency, and they were all located on the tibial side. Except for the physical functions of scale, patients with significant lucency had comparable PROMISE scores to those without lucency. This study examined the short-term outcomes of a novel first-generation talar-ankle replacement system. The survivorship was comparable to that of the INFINITY talar-ankle system and previous studies on the current implant. The reoperation rate was lower than in previous cadence studies, and only one patient required reoperation due to medial gutter impingement, which differs from short-term research of the third-generation system. However, our study population had relatively high periprothetic lucency, predominantly on the tibial side, but the clinical significance and long-term effects of these lucencies remain unknown. In conclusion, this was the first study of cadence talar-ankle arthroplasty system that was not funded by the industry. We found a favorable two-year survivorship and a low reoperation rate. However, additional research with a longer-term follow-up of this cohort is necessary to examine the implant's longer-term survivor. Thank you.

Cadence Toro-Ankle System

short-term results

retrospective study

periprosthetic lucency

long-term survivorship