CME OnDemand: 2022 AOFAS Annual Meeting-Effect of Distal Tibial Cortical Bone Coverage in Rates of Total Ankle Arthroplasty Implant Subsidence, Loosening, Heterotopic Bone Formation and Clinical Outcomes

Effect of Distal Tibial Cortical Bone Coverage in Rates of Total Ankle Arthroplasty Implant Subsidence, Loosening, Heterotopic Bone Formation and Clinical Outcomes

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This study aimed to evaluate the effect of distal tibial cortical bone coverage on the rates of total ankle arthroplasty (TAA) implant subsidence, loosening, heterotopic bone formation, and clinical outcomes. The study included patients who underwent TAA with the Salto Talaris implant from April 2019 to January 2021. The patients were divided into two groups based on whether they received TAA with extended tibial tray and full distal tibial cortical coverage or without extended tibial tray and without full distal tibial cortical coverage. The pre- and post-operative radiographs were evaluated for heterotopic ossification (HO) and subsidence, and range of motion (ROM) was noted. The outcomes included various patient-reported outcome measures (PROs) such as the Veterans RAND-12 Item Health Survey, Ankle Osteoarthritis Scale, Foot and Ankle Ability Measure, Visual Analog Scale for pain, and patient satisfaction.<br /><br />The results of the study showed that patients who underwent TAA with implants offering full distal tibial cortical coverage had less subsidence, lower rates of heterotopic ossification formation, and higher patient satisfaction. There were 122 patients in the study, with 61 in each group, and the mean follow-up was 15.6 months and 22.1 months for Group 1 and Group 2, respectively. The patient characteristics were similar between the two groups in terms of age, gender, and body mass index. Post-operatively, Group 1 showed better scores in the VR-12 physical, VAS pain, and patient satisfaction, compared to Group 2. Additionally, Group 1 had greater plantarflexion range of motion.<br /><br />In conclusion, this study suggests that TAA with implants that offer full distal tibial cortical coverage leads to better outcomes, including less implant subsidence, less heterotopic ossification formation, and higher patient satisfaction. This finding highlights the potential benefit of distal tibial cortical bone coverage in total ankle arthroplasty procedures. The study provides important insights into improving surgical techniques and implant design for TAA surgeries.

Asset Subtitle

Hui Zhang, MD, J. Chris Coetzee, MD, Jeffrey D. Seybold, MD, Bryan D. Den Hartog, MD, Jacquelyn E. Fritz, BS, Rebecca Stone McGaver, MD, Kayla Seiffert, BA, Marc Giveans

Keywords

total ankle arthroplasty

distal tibial cortical bone coverage

implant subsidence

heterotopic bone formation

clinical outcomes

Salto Talaris implant

heterotopic ossification

range of motion

patient satisfaction

implant design