Transfibular Total Ankle Replacement: Midterm Outcomes in 251 Consecutive Cases
Notice bibliographique
Résumé
Research Type: Level 4 – Case series Introduction/Purpose: In contrast to other modern total ankle arthroplasty (TAA) designs, the Zimmer Trabecular Metal Total Ankle (Zimmer-Biomet, Warsaw, IN) is unique in that it utilizes a transfibular approach to the ankle. This allows for a shallow resection depth, and the insertion of a curved prosthesis design, mimicking the native tibiotalar joint. Previously we reported excellent midterm survivorship in 130 ankles. Here we present a follow-up study by a single surgeon analyzing the implant survivorship, clinical, and radiographic outcomes of the transfibular TAA at a minimum of 5-years follow-up. Methods: Retrospective review was performed on prospectively followed patients who underwent primary transfibular TAA by a single surgeon from October 2012 to January 2020. Inclusion criteria included: minimum 5-years of follow-up, patient-reported outcomes measures (PROM), and radiographs. Patient demographics and perioperative data were collected. PROMs included: 12-item Short Form Health Survey (SF-12) physical (PCS) and mental (MCS) component scores, Ankle Osteoarthritis Scale (OAS), and Visual Analog Scale (VAS). Functional outcomes included range of motion (ROM) measured on weightbearing ROM radiographs. Radiographic outcomes included coronal and sagittal alignment, and evaluation of periprosthetic cysts (lucency >2mm) utilizing a 12-zone system. Adverse events and reoperations were reported using the Canadian Orthopedic Foot and Ankle Society (COFAS) Reoperation Coding System (CROCS). A total of 251 ankles (237 patients) with average follow-up of 6.9 years (range, 5.0-12.1) were included in the study. The average age was 59.9 years-old, with 48.5% being females. Results: Postoperative PROMs included SF-12 PCS: 42.0; SF-12 MCS: 54.8; VAS: 2.3; AOS Pain: 19.2; AOS Disability: 27.0. Postoperative tibiopedal ROM was 18.2° dorsiflexion and 21.6° plantarflexion; tibiotalar ROM was 9.1° dorsiflexion and 18.0° plantarflexion. A total of 9 (3.6%) ankles had at least one cyst, most commonly located about the posterior talar component (Zone 12), with no patients having more than 2 cysts. Reoperation rate was 35.1% (n=88) at average 25.5 months, most commonly medial gutter debridement (n=36, 14.3%). One (0.4%) implant revision was performed for tibial component subsidence. There were 9 (3.6%) cases of acute infection, 6 requiring polyethylene exchange, 3 requiring only I&D and removal of fibular hardware. Overall implant survival, defined by retention of the metal components, was 99.6%. Conclusion: Midterm outcomes of the transfibular TAA continue to demonstrate sustained improvements with respect to patient-reported outcomes and radiographic alignment. A third of patients may require elective reoperations, most commonly for medial gutter impingement. There is a relatively low incidence of periprosthetic cysts and component failure requiring revision during this time period, and there were no incidences of fibular nonunion.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».