Outcomes of Laterally Inserted Trabecular Metal Total Ankle Arthroplasty Comparing Cemented and Cementless Rail Fixation: A Prospective, Longitudinal Study
Bibliographic record
Abstract
Background: This study investigated performance and safety differences between cemented and cementless fixation of trabecular metal total ankle arthroplasty (TAA) using a lateral transfibular approach. Methods: This nonrandomized, multicenter, prospective study included 59 cemented and 61 cementless TAA patients with mean follow-ups of 7.2 years (cemented) and 6.2 years (cementless). All cemented ankles were performed in North America; cementless fixation was performed in Europe. Implant survival (revision of tibial or talar implant for any reason) was the primary outcome. Secondary outcomes were radiographic measures and range of motion. Tertiary outcomes included American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Ankle Osteoarthritis Scale (AOS), and EuroQol 5-Dimension 5-Level (EQ-5D-5L). Results: At average 7 years’ combined follow-up, there were no significant differences ( P = .08) in survival between cemented (100%) and cementless (94.88%, 95% CI 84.94%-98.32%) fixation. More mid- and hind-foot fusions were performed in the cemented (n = 16) vs cementless cohort (n = 1, P < .05). Plantarflexion was similar between the cohorts through 7 years postoperative. Dorsiflexion was significantly greater in the cementless cohort from 6 weeks through 5 years postoperative. At 6 weeks postoperative, AOFAS, AOS pain, AOS disability, and EQ-5D-5L scores were significantly better in the cementless cohort ( P < .05). AOS disability and EQ-5D-5L scores remained better in the cementless cohort through 2 years and 1 year postoperative, respectively. Outcomes were similar between the groups at later time points. Postoperative patient satisfaction rates were similar for the groups: 95.9% (6 weeks), 90.0% (6 months), and 91.3% (1 year). Conclusion: TAA using a trabecular metal ankle implant with a transfibular approach was associated with excellent survival regardless of fixation. Greater improvements in function, pain, range of motion, and quality of life 6 weeks postoperative suggest faster recovery with cementless fixation; however, this may reflect an increased number of additional procedures performed in the cemented cohort.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".