DOI: https://doi.org/10.22141/1608-1706.5.19.2018.146651

Results of total ankle arthroplasty according to national registers: a meta-analysis

T.M. Omelchenko, O.A. Buryanov, A.P. Lyabakh, M.V. Kotova, O.A. Turchin

Abstract


Background. The purpose was to conduct a systematic review and meta­analysis of the results of total ankle arthroplasty in terms of survival rates of various implants, the time and number of revisions, the nature of complications. Materials and methods. Data from open national medical registers of Scandinavian countries (Norway, Sweden, Finland), New Zealand, Australia, etс. were used, as well as articles, scientific works in specialized professional publications, abstracts, open electronic databases, databases of the USA National Library of Medicine — Medline for the last 15 years. Statistical analysis was used taking into account survival and revision evaluations by the Kaplan­Meier method, dispersion analysis, nonparametric analysis of the Spearman rank correlation. Results. The general trends shown in the study indicate a predictable risk of revision in 10–15 % of patients by the end of 5 years after arthroplasty and in up to 20–30 % — by the end of 10 years. In most studies, revision arthroplasty or arthrodesis were considered as the endpoint in determining survival rates. However, if the period of time before the revision is considered as the endpoint for a negative result, the survival rates of the endoprosthesis are further reduced. In addition to aseptic instability and infectious complications, progressive pain syndrome is another problem that can jeopardize the clinical outcomes. Conclusions. Three­component prostheses with mobile polyethylene insert and cementless type of fixation have better results and are characterized by greater survival in comparison with prostheses of the previous generations. The key elements of modern designs are the minimally possible bone resection and improved multicomponent porous coating. When choosing treatment, it is important to take into account the individual characteristics of the patient, such as body mass index, smoking status, comorbidity and other variables that can help predict the results and survival of implants. In addition, the choice of treatment and prosthesis should be conditioned by the knowledge of the surgeon about the constructive features of the prosthesis, as well as their availability.


Keywords


ankle joint arthroplasty; systematic review; meta-analysis

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