Accuracy assessment of measuring component position after total ankle arthroplasty using a conventional method

Kyoung-Jai Lee,Shao-Hua Wang,Keun-Bae Lee,Gun-Woo Lee

doi:10.1186/s13018-017-0611-2

Kyoung-Jai Lee, Shao-Hua Wang + Show 2 more

Open Access

https://doi.org/10.1186/s13018-017-0611-2

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Abstract

BackgroundThis study was to assess the accuracy of measuring the tibial and talar components position and to investigate the outlier rate of each component and predisposing factors related to component malalignment after total ankle arthroplasty (TAA) using a conventional method.MethodsOne hundred fifty consecutive primary total ankle arthroplasty were performed using the three-component HINTEGRA prosthesis for ankle end-stage osteoarthritis. Radiographic analysis for the accuracy of component position in coronal and sagittal plane was conducted at postoperative 6 months. Additionally, the accuracy of component position was evaluated according to presence of preoperative deformity or joint incongruency.ResultsThe mean postoperative coronal angles of the tibial and talar components (α and γ) were 91.9° and 91.3°. The mean postoperative sagittal angles of the tibial and talar components (β and δ angle) were 84.6° and 91.7°. In the coronal plane, 16 (10.7%) tibial components and 15 (10.0%) talar components showed outliers greater than 5°. In sagittal plane, 15 (10.0%) tibial components and 29 (19.3%) talar components showed outliers greater than 5°. There was no meaningful increase of the outlier rate regarding presence of preoperative deformity or joint incongruency.ConclusionsIn conventional method of TAA, the outlier rate of the tibial and talar components was about 10 to 20%, especially, the outlier rate of talar component in sagittal plane was up to 20%. Therefore, careful attention should be paid to implant the talar component in conventional TAA.

Highlights

This study was to assess the accuracy of measuring the tibial and talar components position and to investigate the outlier rate of each component and predisposing factors related to component malalignment after total ankle arthroplasty (TAA) using a conventional method
As done with coronal plane analysis, we evaluated the accuracy of component position depending on preoperative sagittal deformity: extension, neutral, and plantar flexion
The most important finding of the present study is that the outlier rate of component was higher than we expected, and the outlier rate of each component in coronal plane is about 10%, but the talar component position in sagittal plane showed the outlier rate up to 20%

Summary

Introduction

This study was to assess the accuracy of measuring the tibial and talar components position and to investigate the outlier rate of each component and predisposing factors related to component malalignment after total ankle arthroplasty (TAA) using a conventional method. The success of joint arthroplasty depends on many factors, including patient selection, prosthetic design, soft tissue balancing, severity of joint deformity, and component position [11,12,13,14,15,16,17]. Among these factors, proper component position is one of the most important factors, which influences the longevity of the implant. Previous studies have reported radiographic outcomes and predisposing factors that increase the risk of postoperative malalignment after hip or knee joint arthroplasty.

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