Arthrodesis may be better indicated after failed TAR than re-arthroplasty.

Published on: 5 September, 2014

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Globally there has been a trend towards increased use of total ankle arthroplasty. With this, comes an inevitable increased need to revise the prostheses, with component exchange and revision procedures often considered.

Australians surgeons however, do not seem to be following the trend, with a decreasing number of ankle replacement procedures being performed. From a peak in 2011 with 324 ankle replacements performed, the number in 2013 decreased to 251. Currently in 2014 only 90 have been performed so far. Perhaps Australian surgeons have anecdotally found the same results as those of a recent US study, and are showing a preference for ankle fusion?

A recent study reviewed 140 patients who underwent primary total ankle arthroplasty (TAR) and two types of revisions. The results demonstrated that patients with TAR may have better outcomes with ankle fusion, should they require a revision.

In an article in Orthopaedics Today Europe about the study results, investigator Ilka Kamrad, MD, said patients who underwent ankle fusion had similar function to those who underwent revision TAR, and both groups showed similar levels of satisfaction.
“Revision total ankle replacement does not seem to be superior to ankle fusion after a failed primary total ankle replacement, but larger study groups are needed to better compare the outcomes of the two procedures,” Kamrad said during his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.

Does this mean that ankle fusion has also become the procedure of choice for Australian surgeons?

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